CVS History

FOCUSED CVS HISTORY TAKING

1. Introduction: Introduce yourself first

2. Patient’s demographic data:

   • Age: Coronary artery disease & peripheralvascular disease more common in old people
   • Nationality
   • Occupation: Ask if sitting or physical exertion at work. Any stress at work? (Physical exertion precipitates angina. Stress also can worsen angina)
   • Housing: Ground floor or above (climbing stairs precipitates angina)

3. Chief complaints CVS

4. History of chief complaints : ask details of the main problem

5. Past medical history: any cardiac problem, HTN, DM, high cholesterol ( risk factors for angina and MI)

6. Family history: ischemic heart disease , HTN often run in families

7. Personal/Social history: smoking, alcohol, recreational drugs, stress( all are risk factors for ischemic heart disease)

8. Medicines Some medicines can damage the myocardium

COMMON CVS DISEASES

• Coronary artery disease (angina, Myocardial infarction)
• Congestive heart failure
• Arrhythmias (atrial fibrillation)
• Pericarditis
• Endocarditis
• Peripheral vascular disease

SIGNS & SYMPTOMS

Cardio vascular diseases can present with the following:

1. History of Chest Pain (coronary artery disease, pericarditis sometimes arrhythmias)
2. Dizziness/ Syncope (heart failure, aortic valve diseases, Hypotension, Ischemic Heart Disease)
3. Dyspnea (angina/MI, heart failure)
4. Palpitations’ due rapid HR (angina, MI, arrhythmias, hypertension)
5. Fatigue (heart failure)
6. Orthopnea: *Supine position produces dyspnea. Occurs in HF
7. Nausea/sweating (anginal attack, MI)
8. Claudication: peripheral vascular disease
9. Fever Occurs in endocarditis (infection of the heart valves)

SUMMARY OF FEATURES

1. Angina/MI:

• Causes chest pain - Usually in adults
• Pain may radiate to the neck, jaw, left arm
• Risk factors are: fam. Hist, smoking, DM, HTN high cholesterol
• Precipitated by exertion, relieved by rest
• Sharp, pressure like
• Pain comes and goes in angina
• Often associated with sweating, palpitations, nausea, dizziness

2. Pericarditis:

• Pain not very severe * Persistent
• Worse while supine, better by leaning
• No radiation * Occurs gradually
• Pricking pain

3. Valve problems: Can lead to dizziness, syncope, palpitations, dyspnea

4. Hypertension: Can be asymptomatic or produce headache, general body pain, dizziness

5. Heart failure:

• No chest pain
• dyspnea
• fatigue
• Orthopnea
• Pedal edema

6. Arrhythmias: Produce palpitations, dizziness, syncope, can be asymptomatic

7. Peripheral vascular disease: pain on walking

8. Endocarditis: No chest pain. Fever present