PD - History Taking of Patients with Cardiovascular Problems

History taking

What is considered the cornerstone for diagnosis when carefully obtained?

Rapport building

What is the main purpose of history taking aside from diagnosis?

Attentive history taking

What establishes a bond with the patient during medical interviews?

Physician-patient bond

What helps secure patient compliance in treatments and hospitalizations?

Physician’s evaluation

What determines whether symptoms are organic or psychological?

Filter information

What is the physician’s responsibility when a patient presents irrelevant information?

Laboratory tests

What should supplement clinical history and physical examination findings?

Coronary circulation, electrical system, pumping ability

What are the three main components of the heart to assess in cardiovascular history?

Coronary circulation

What system of the heart relates to chest pain syndrome?

Electrical system

What system of the heart relates to palpitations and syncope?

Pumping ability

What system of the heart relates to edema and dyspnea?

Chest pain, palpitations, dyspnea, edema, syncope

What are the five common symptoms of cardiovascular disease?

Lungs

What is the right heart responsible for pumping blood into?

Systemic circulation

What is the left heart responsible for pumping blood into?

Chest pain

What symptom suggests a problem in oxygen supply and demand balance?

Underlying etiology

What is the first element of a complete cardiac diagnosis?

Anatomic abnormalities

What is the second element of a complete cardiac diagnosis?

Physiologic disturbance

What is the third element of a complete cardiac diagnosis?

Functional disability

What is the fourth element of a complete cardiac diagnosis?

New York Heart Association classification

What classification is used to determine the level of functional disability in heart disease?

Class I

Which New York Heart Association class indicates no limitation of activity?

Class III

Which class indicates marked limitation of physical activity?

Class IV

Which class indicates symptoms even at rest?

Class II

Which class indicates slight limitation of physical activity?

Chest discomfort

What symptom is caused by myocardial ischemia?

Fatigue and dyspnea

What symptom results from impaired contraction or relaxation?

Valvular problem

What symptom is due to obstruction to blood flow?

Palpitation

What symptom is due to abnormal rhythm or rate?

Venous congestion

What causes peripheral edema in right-sided heart failure?

Cor pulmonale

What is right-sided heart failure secondary to lung disease called?

End-stage heart failure

What happens when both sides of the heart fail?

Chest pain

What is the most common symptom of coronary heart disease?

Levine sign

What gesture is a classic sign of ischemic chest pain?

18%

What percentage of myocardial infarction cases present with classic exertional pain?

Stable angina

What type of angina is relieved by rest or nitrates?

Myocardial infarction

What kind of pain radiates to jaw and left arm at rest?

Myocardial ischemia, cardiopulmonary, non-cardiopulmonary

What are the three triage categories for chest discomfort?

Ischemic pain

What type of pain is described as tightening, pressing, or strangling?

Aortic dissection

What condition causes tearing or ripping pain in the anterior chest?

Pericarditis

What condition causes sharp, pleuritic pain relieved by sitting up?

Esophageal reflux

What condition causes burning pain worsened after meals and relieved by antacids?

Gallbladder disease

What chest pain radiates to right upper quadrant and back after meals?

More than 30 minutes

What is the typical duration of chest pain in myocardial infarction?

2-10 minutes

What is the typical duration of chest pain in stable angina?

Acute aortic syndrome

What condition has sudden, unrelenting tearing pain associated with hypertension?

Pulmonary embolism

What cardiac condition presents with pleuritic chest pain and dyspnea due to embolus?

Esophageal spasm

What non-cardiac condition may mimic angina with postprandial burning?

Costochondritis

What neuromuscular cause of chest pain is reproducible by pressure on the joint?

Shingles

What is the name of chest pain due to herpes zoster rash?

Panic attack

What emotional condition can mimic chest tightness with dyspnea?

Palpitation

What is the awareness of one’s own heartbeat called?

Anxiety, hyperthyroidism, electrolyte imbalance

What non-cardiac causes can lead to palpitations?

Supraventricular tachycardia

What arrhythmia causes abrupt onset and termination of palpitations with neck pulsation?

Sinus tachycardia

What condition causes gradual acceleration and slowing of heartbeat?

Electrocardiogram

What test confirms irregular cardiac rhythm?

Dyspnea

What is the subjective experience of breathing discomfort?

Orthopnea

What type of dyspnea occurs when lying flat and improves when sitting up?

Paroxysmal nocturnal dyspnea

What type of dyspnea awakens the patient 1–2 hours after sleep?

Platypnea

What type of dyspnea occurs only in the upright position?

Heart failure

What condition is commonly associated with orthopnea and paroxysmal nocturnal dyspnea?

Exertional dyspnea

What type of dyspnea is triggered by exercise or exertion?

Left side

What side of the heart commonly causes pulmonary congestion and shortness of breath?

Constrictive pericarditis

What pericardial condition causes dyspnea due to restricted filling?

Edema

What is the increase in interstitial fluid volume called?

Pitting edema

What kind of edema leaves an indentation after pressure application?

Stage II

What stage of edema is limited below the knees?

Stage IV

What stage of edema involves ascites and anasarca?

Venous congestion

What mechanism primarily causes cardiac edema?

Renin-angiotensin-aldosterone system

What system activation causes renal vasoconstriction and water retention?

Sympathetic nervous system

What hormone system is activated in heart failure causing sodium retention?

Kidney failure

What renal condition leads to edema with low urine output?

Liver cirrhosis

What hepatic condition is commonly associated with ascites?

Nephrotic syndrome

What renal syndrome presents with periorbital edema and proteinuria?

Syncope

What is a transient loss of consciousness due to reduced cerebral blood flow?

Vasovagal syncope

What type of syncope results from emotional stress or standing too long?

Orthostatic hypotension

What type of syncope occurs due to autonomic failure when standing?

Cardiac syncope

What type of syncope is caused by arrhythmias or structural heart disease?

Postictal drowsiness

What symptom differentiates seizure from syncope due to prolonged recovery?

Quick reorientation

What symptom differentiates syncope from seizure due to short recovery time?

Diabetes mellitus

What comorbidity should be asked in suspected hypoglycemic syncope?

Laughter or anger

What emotional trigger may cause cataplexy?

Hyperthyroidism

What thyroid condition may cause palpitations or heart failure?

Diabetes mellitus

What metabolic disease increases risk of coronary artery disease?

Marfan syndrome

What autoimmune disease predisposes to aortic aneurysm?

Streptococcal infection

What bacterial infection following dental extraction may cause endocarditis?

Rheumatic fever

What prior illness commonly causes valvular disease?

Angioplasty

What previous cardiac intervention confirms ischemic heart disease?

Stroke

What neurologic event is associated with atrial fibrillation?

Premature coronary artery disease

What familial condition increases risk for early myocardial infarction?

Cyanotic heart disease

What congenital abnormality may cause clubbing of fingernails?

Hypertension and diabetes

What two lifestyle-related diseases must be asked in family history?

Rubella

What viral infection during pregnancy may cause congenital heart disease?

Smoking

What is the most significant modifiable risk factor for heart disease?

Alcohol

What substance abuse can cause cardiac arrhythmia and cardiomyopathy?

Cocaine and methamphetamines

What illicit drugs can cause myocardial infarction in young adults?

High-fat diet

What dietary pattern contributes to coronary artery disease?

Sedentary lifestyle

What lifestyle factor reduces cardiac output efficiency?

Pack-years

What unit is used to quantify smoking exposure?

Preeclampsia

What pregnancy complication may lead to later cardiovascular disease?

Peripartal cardiomyopathy

What cardiac condition develops after childbirth?