Symptoms and Symptoms and Signs of CVSSigns of CVSProf. Khalid AL-Marzouki Prof. Khalid AL-Marzouki

Symptoms of CVSSymptoms of CVS

Three main symptomsThree main symptoms::

11--Pulmonary Congestive Pulmonary Congestive SymptomsSymptoms::

A-DyspneaA-Dyspnea::

Grade 1 on mild ExertionGrade 1 on mild Exertion..

Grade 2 on moderate ExertionGrade 2 on moderate Exertion..

Grade 3 on severe ExertionGrade 3 on severe Exertion..

Grade 4 at RestGrade 4 at Rest..

Symptoms of CVSSymptoms of CVS

B- OrthopneaB- Orthopnea..

C- Paroxysmal Nocturnal Dyepnea C- Paroxysmal Nocturnal Dyepnea (PND)(PND)..

D- Cough with or without sputumD- Cough with or without sputum..

E- Cardiac Asthma ( Wheezes)E- Cardiac Asthma ( Wheezes)..

F- Pulmonary Edema: Scanty, whitish F- Pulmonary Edema: Scanty, whitish frothy sputumfrothy sputum . .

Symptoms of CVSSymptoms of CVS

22--Systemic Congestive SymptomsSystemic Congestive Symptoms::

A-Congested Neck Veins ( JVP)A-Congested Neck Veins ( JVP)..

C- Congested Liver: RT C- Congested Liver: RT Hypochondrium painHypochondrium pain..

D- Abdominal SwellingD- Abdominal Swelling..

E- Bilateral Lower Limb SwellingE- Bilateral Lower Limb Swelling . .

Symptoms of CVSSymptoms of CVS

33--Low Output SymptomsLow Output Symptoms::

A- To BrainA- To Brain: Guideness, Dizziness, : Guideness, Dizziness, Fainting Attacks and Syncopal Fainting Attacks and Syncopal AttacksAttacks..

B-To HeartB-To Heart: Chest pain, Easy : Chest pain, Easy Fatigability and Intermittent Fatigability and Intermittent ClaudicationClaudication..

* *Palpitation: Awareness of Heart beatPalpitation: Awareness of Heart beat..

Signs of CVSSigns of CVS

11--Vascular SignsVascular Signs : :

A- Arterial. B- VenousA- Arterial. B- Venous..

22 - -Cardiac SignsCardiac Signs..

Vascular SignsVascular Signs

11 - -ArterialArterial::

--Pulse. - Blood Pulse. - Blood PressurePressure..

22 - -VenousVenous::

- -Pulse wave. - Venous Pulse wave. - Venous pressurepressure..

Vascular SignsVascular Signs

--Arterial PulseArterial Pulse::

11 - -RateRate..

22 - -RhythmRhythm..

33 - -VolumeVolume..

44 - -Equality in both handsEquality in both hands..

55 - -Radio- Femoral delayRadio- Femoral delay..

66 - -Pulse of special characterPulse of special character::

A- Pulsus Parvus: (Small pulse volume), A- Pulsus Parvus: (Small pulse volume), pulse pressure < 30 mm Hgpulse pressure < 30 mm Hg..

B- Pulsus Tardus ( plateau)B- Pulsus Tardus ( plateau)..

C- Bounding PulseC- Bounding Pulse..

D- Collapsing Pulse ( Water Hammer D- Collapsing Pulse ( Water Hammer Pulse), pulse pressure > 60 mm Hg + Pulse), pulse pressure > 60 mm Hg + DBP < 60 mm HgDBP < 60 mm Hg..

E- Pulsus AlternansE- Pulsus Alternans..

F- Pulsus ParadoxusF- Pulsus Paradoxus..

G- Pulsus BisferenceG- Pulsus Bisference..

H- Pulsus TrigemenusH- Pulsus Trigemenus..

--Venous PulseVenous Pulse::

A + V wave, X+Y DescentA + V wave, X+Y Descent..

--Venous Pressure (JVP)Venous Pressure (JVP)..

Cardiac SignsCardiac Signs

11 - -InspectionInspection::

--Pulse (precordial area)Pulse (precordial area)::

**Localized “ LVLocalized “ LV””

**Diffused “RVDiffused “RV””

--Bulging (precordial area)Bulging (precordial area)

Cardiac SignsCardiac Signs

22 - -PalpationPalpation::

A- Site of the ApexA- Site of the Apex..

B- Character of Apex beatB- Character of Apex beat;;

* * NormalNormal..

* * TappingTapping..

* * Heaving: sustained or unsustainedHeaving: sustained or unsustained..

Cardiac SignsCardiac Signs

C- Palpable Murmur (Thrill)C- Palpable Murmur (Thrill)

D- Palpable 2D- Palpable 2ndnd Heart Sound Heart Sound..

E- Parasternal HeaveE- Parasternal Heave..

Cardiac SignsCardiac Signs

33 - -AuscultationAuscultation::

* *Heart Sounds 1Heart Sounds 1stst+ 2+ 2ndnd. .

* * Added Sounds 3Added Sounds 3rdrd + 4 + 4thth, click and , click and opening snapopening snap..

* * MurmursMurmurs..