cvs disease

8/8/2019 CVS Disease

1/24

In The Name Of ALLAH,The Most Beneficent,

The Most Gracious,The Most Merciful !


2/24

CARDIOVASCULAR SYSTEM


3/24

PRESENTED BY:

Prof. Muhammad ZafarM.B;B.S., M.PHIL., PH.D


4/24

SYMPTOMS OF CVS DISEASES


5/24

Following are the main symptoms of CVS disea

1.Chest pain (discomfort)

2.Breathlessness (Difficulty in Breathing)3.Palpitation

4.Syncopial attacks (Syncope)

5.Peripheral oedema


6/24

1. Chest pain / discomfort this

occurs due to angina, myocardial

infarction, pericarditis and rarely

aortic dissecting aneurysm. Cardiacpain is retrosternal, pressure like

i.e. squeezing and radiates to left

shoulder and arm (may be in jaws

or upper abdomen).


7/24

Continue..

It is of shorter duration in case ofangina and prolonged (more than

half hour) in cases of myocardial

infarction. Pain is relieved by rest

(occurs with exertion) and taking

sublingual nitroglycerine tablet

shows anginal pain. Pericarditis

pain is central. It is increased withinspiration and changes with

posture and disappears with

NSAID.


8/24

PAIN

1.Site2.localized or diffuse?

3.Radiate

4.Character (Burning, stabbing, crushing,

gripping, pricking, dull, colicky)5.Intensity (mild, moderate, severe)

6.Factors which aggravate?

7.Factors which relieve?8.Is pain associated with some other

symptoms?

9.Relationship of posture with pain

10.Pain continuous or intermittent?


9/24

2. BREATHLESSNESS (Dyspnoea)

Following should be asked:

1.What are the circumstances under which

attack of dyspnoea occurs i.e. after

exercise and exertion or in lying on bed(orthopnoea)? If dyspnoea occurs after

exertion, what is the grade of exertion i.e.

severe, moderate or mild.2.Does dyspnoea appear suddenly

(pulmonary oedema, asthma) or gradually

(advance chest or heart disease)?


10/24

BREATHLESSNESS continue

3.What is the character of breathing? Is it

rapid, wheezing or labored?

4.What is the degree of distress? Does the

patient collapse while having the attack of

dyspnoea (dyspnoea syncope).

5.Is the patient free from symptoms inbetween the attacks (Asthma)?


11/24

In paroxsmal nocturnal dyspnoea, patient is

comfortable lying down to sleep but is

woken later with acute, severe,breathlessness which is relieved by sitting

up.


12/24

3. Palpitation awareness of heartbeat islabeled as palpitation. During emotional

upset or after exercise it is a common

physiological phenomenon. Palpitation may

occur due to abnormal cardiac rhythm i.e.

extra systole or tachycardias. Atrial

fibrillation,supraventricular tachycaedia

(SVT) are common causes. Few patientsmay complain of dropped or missed beats.


13/24

Palpitation: (continued)

Ask about:

1. The mode of onset and termination

2. Specific triggers of exercise, alcohol,caffeine

3. Frequency

4. Duration of attacks5. Rhythm


14/24

4. Syncope (dizziness or loss ofconsciousness) this occurs due to abrupt

cerebral hypo function as a result of

transient hypotension (postural

hypotension). Cardiac causes are

arrhythmia, bradycardia, and aortic stenosis.

Other non-cardiac causes include stroke,

epilepsy and vosovagal syncope.


15/24

5. Peripheral oedema pitting oedema of

lower limbs is cardinal feature of CCF. This

can occur in cases of Hypoproteinemia,and kidney disease.


16/24

SIGNIFICANCE OF HISTORY TAKING

FROM A CVS PATIENT

THE HISTORY:

The history is as important as clinical

examination in the evaluation of the patientwith cardiac disease. Indeed the most

common cause of cardiac symptoms,

coronary heart disease, commonly occurswithout abnormal physical findings.


17/24

PRESENTING COMPLAINT

Establish the frequency, duration and

severity of symptoms and causative and

relieving factors.


18/24

FUNCTIONAL IMPAIRMENT

Assess the impact of symptoms of exertional

chest pain or breathlessness on the patients

functional capacity.


19/24

PAST HISTORY

Rheumatic feverHeart murmurs during childhood

Specifically enquire about conditions associated

with cardiac disease, including:Diabetes mellitus

Glomerulonephritis and hypertensive heart

disease

Thyrotoxicosis and atrial fibrillationAmyloidosis and cardiomyopathy

In cases of suspected infective endocarditis

ask about recent dental work


20/24

DRUG HISTORY

Thyroxine may precipitate or aggravate angina.

Non-steroidal anti-inflammatory drugs

Herbal remedies


21/24

Genetically determined cardiovascular disorders

Single-gene defects Polygenic inheritance

Hypertrophic

cardiomyopathy

Ischaemic heart disease

Marfans syndrome Hypertension

Familial

hypercholesterolaemia

Type 2 diabetes mellitus

Muscular dystrophies Hyperlipidaemia

Long Q-T syndrome

FAMILY HISTORY


22/24

SOCIAL HISTORY

Smoking

Consumption of alcohol

Caffeine consumption


23/24

OCCUPATIONAL HISTORY

3.15 Occupational aspects of cardiovascular disease

Occupational exposure associated with cardiovascular disease

Organic solvents Arrhythmias

cardiomyopathy

Vibrating machine tools Raynauds phenomenon

Publicans Alcoholic cardiomyopathyOccupational exposure exacerbating pre-existing cardiac conditions

Cold exposure Angina

Raynauds diesase

Deep-sea diving Embolism through foramen ovale

Occupational requirements for high standards of cardiovascular fitness

Pilots

Public transport / heavy goods vehicle drivers

Armed forces

police


24/24

THANK YOU

cvs disease

Documents