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SYMPTOMTOLOGY OF
CARDIOVASCULAR
DISEASES
SYMPTOMTOLOGY OF
CARDIOVASCULAR
DISEASES
DYSPNEA
CHEST PAIN
PALPITATIONS
DIZZINESS & SYNCOPE
PERIPHERAL EDEMA
SYSTEMIC SYMPTOMS
2
SYMPTOMTOLOGY OF
CARDIOVASCULAR DISEASES
1)DYSPNEA
DEFINITION
 ONSET

Sudden
 Ac. LVF
 H.T.
 M.I.
Arrhythmia
3
DYSPNEA
Onset- cont
Gradual

H.T.
IHD
VHD
Fluid overload

4
DYSPNEA-cont





AGGRAVATING FACTORS
RELIEVING FACTORS
ORTHOPNEA
Dyspnea on lying flat
PND
Dyspnea occurs suddenly ½ hr. to 4 hr.
after going to bed & is relieved
after
10 –20 minutes
5
PAROXYSMAL NOCTURNAL DYSPNEA
DYSPNEA-cont
NEW YORK HEART ASSOCIATION
CLASSIFICATION
GRADE-1
No breathlessness
GRADE-2
Breathlessness on moderate
exertion
GRADE-3
Breathlessness on mild
exertion
GRADE-4
Breathlessness at rest
7
Symptomtology- cont
2) CHEST PAIN OR DISCOMFORT
ANGINA PECTORIS
M.I.
PERICARDITIS
AORTIC DISSECTION
MISCELLANEOUS CAUSES
8
CHEST PAIN. Cont
1)ANGINA PECTORIS
Cardiac pain due to myocardial ischemia
 SITE
 RADIATION
 DURATION
 CHARACTER
 AGGRAVATING FACTOR
 RELIEVING FACTORS
 ASSOCIATED SYMPTOMS
9
Chest painANGINA. Cont
1)SITE & RADIATION
CENTRAL
OPEN HAND OR FIST(rather than
pinpoint)
EPIGASTRIC
L- ARM,BOTH ARMS, JAW

10
SITE & RADIATION OF ANGINA
Chest painANGINA. Cont
2)DURATION & AGGRAVATING & RELIEVING
FACTORS
 5-20 minutes
 Exertion
 Excitement
 Cold
 Exercise after meal
 Functional activity
 Rest
 GTN
12
Chest painANGINA. Cont
CANADIAN CARDIOVASCULAR SOCIETYFUCTIONAL CLASSIFICATION

Grade-1 No limitation
Grade-2 Slight limitation
Grade-3 Marked limitation
Grade-4 Pain at rest

13
Chest painANGINA. Cont
3)CHARACTER

Discomfort rather than pain
Tightness
Heaviness

14
Chest painANGINA. Cont
4)ASSOCIATED SYMPTOMS
Dyspnea
Sweating
Vomiting
Nausea

Usually absent

15
Chest painANGINA. Cont
TYPES OF ANGINA

EFFORT ANGINA
UNSTABLE ANGINA
DECUBITUS ANGINA
CRESCENDO ANGINA

16
Chest painANGINA. Cont
ATYPICAL SYMPTOMS
Risk factors
Age
Sex
Smoking
H.T.
Diabetes
17
Chest pain -cont
B ) MYOCARDIAL INFARCTION
SITE & RADIATION
SEVERITY
DURATION
PPT. FACTORS
RELIEVING FACTORS
ASSOCIATED SYMPTOMS
PAINLESS M.I.
18
Chest pain -cont
C-PERICARDITIS
More localized(Central or lateral chest wall)
Sharp-Stabbing or raw
No radiation
Changes with breathing & posture
Improves with NSAID’S
Preceded by viral illness
19
Chest pain -cont
D-AORTIC DISSECTION
H/O H.T., Marfans synd,Aortic
aneurysm,Chest trauma
Sudden
Central –b/w scapulae
Tearing
Associated features
20
Chest pain -cont
E- MISCELLANEOUS CHEST PAIN
CAUSES
Precordial catch (Da-Costa’s synd.)
M.V.P.

21
Symptomtology- cont
C- PALPITATIONS
Awareness of heart beat
SINUS RHYTHM
SUSTAINED ABNORMAL RHYTHM
OCCASIONAL IRREGULARITIES OF
RHYTHM
All patients of arrhythmia may not be
symptomatic(A.F.)
22
PALPITATIONS-cont
ASK ABOUT:
Onset & termination
Triggering factors
Exercise
Alcohol
Caffeine
Anxiety

Frequency
Duration of attack
Rhythm
Associated features

23
PALPITATIONS-cont
a) Palpitations in sinus rhythm
EXERCISE
ANXIETY
STRESS
CAFFIENE
SMOKING
NIGHT TIME
24
PALPITATIONS-cont
b) SUSTAINED ABNORMAL RHYTHM
Sudden
Minutes to hours
Unrelated to anxiety
ASK ABOUT:
Family h/o sudden death
Past h/o I.H.D.
Drugs
25
PALPITATIONS-cont
c) ECTOPIC BEATS
Felt as missed beats
Ventricular
Benign in 10-15 %
At rest
Disappear with exercise

Atrial
26
Symptomtology- cont
4)SYNCOPE & DIZZINESS

Dizziness- non cardiac
Syncope
Pre-syncope CARDIAC
Cardiac causes of syncope
 Postural hypotention
 Arrhythmia
 L.V. Outflow obstruction
27
Syncope- cont
1)Postural hypotention

Definition
Drugs
Dehydration
A.N. Neuropathy

28
Syncope- cont
2)Arrhythmias
Bradyarrythmias
Sick sinus synd.
CHB
Drugs

Ventricular tachycardias

29
Syncope- cont
3)L.V. Outflow obstruciton
Severe A.S.
H.O.C.M.
4)Other cardiac causes
Enhanced vagal sensitivity(Bradycardia + Vasodilatation)
 Fright
 Fear
 Micturition
 Cough

Carotid sinus hypersensitivity
 Uncommon
 Elderly
 Atrial myxoma

30
Symptomtology- cont
5)PERIPHERAL EDEMA
Symptom
Sign
ANKLE
Unilateral
 DVT
 Cellulites
 Trauma
 Hemiplegia
31
Edema- cont.
Bilateral
CCF
Hypoprotenemia
Lymph. Obstruction
I.V.C. obstruction
Immobility

SACRAL
GENERALISED
32
Symptomtology- cont
6)SYSTEMIC SYMPTOMS

a) Fatigue





Heart failure
Sustained arrhythmia
Cyanotic heart disease
Drugs

b)Anorexia
THE END
33

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