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    Symptoms of Cvs

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    studymedic
    The document describes symptoms of cardiovascular disease including dyspnea, orthopnea, palpitations, and chest pain. It then explains the mechanisms behind several key symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea which can occur due to pulmonary congestion from left ventricular failure and increased left atrial pressure. Chest pain can result from issues like angina, myocardial infarction, or pericarditis. Low cardiac output can also cause symptoms through reduced venous return or cardiac filling.

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    Symptoms of Cvs

    Uploaded by

    studymedic
    172 views25 pages
    The document describes symptoms of cardiovascular disease including dyspnea, orthopnea, palpitations, and chest pain. It then explains the mechanisms behind several key symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea which can occur due to pulmonary congestion from left ventricular failure and increased left atrial pressure. Chest pain can result from issues like angina, myocardial infarction, or pericarditis. Low cardiac output can also cause symptoms through reduced venous return or cardiac filling.

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    The document describes symptoms of cardiovascular disease including dyspnea, orthopnea, palpitations, and chest pain. It then explains the mechanisms behind several key symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea which can occur due to pulmonary congestion from left ventricular failure and increased left atrial pressure. Chest pain can result from issues like angina, myocardial infarction, or pericarditis. Low cardiac output can also cause symptoms through reduced venous return or cardiac filling.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    172 views25 pages

    Symptoms of Cvs

    Uploaded by

    studymedic
    The document describes symptoms of cardiovascular disease including dyspnea, orthopnea, palpitations, and chest pain. It then explains the mechanisms behind several key symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea which can occur due to pulmonary congestion from left ventricular failure and increased left atrial pressure. Chest pain can result from issues like angina, myocardial infarction, or pericarditis. Low cardiac output can also cause symptoms through reduced venous return or cardiac filling.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 25

    SYMPTOMS of CVS

     Dyspnea
     Orthopnea
     Paroxysmal nocturnal dyspnea (PND)
     Cough
     Haemoptysis
     Syncope
     Fatigue
     Palpitations
     Chest pain
    DYSPNEA
    “Awareness of respiratory effort”

    Causes of dyspnea:

     Physiological
     Cardiac
     Respiratory
     Abdominal
     Metabolic
     Anaemia
     Psychogenic
     Cardiac causes of dyspnea:

    • Left ventricular failure


    • Mitral valve disease
    • Cadiomyopathy
    • Constrictive pericarditis and pericardial
    effusion
    ORTHOPNEA
    “Respiratory distress on lying down”

    Mechanism:
    1. Venous return and cardiac output are
    increased by 25% on lying down
    2 Reabsorption of edema fluid from lower
    limb into the circulation
    3 Viscera push the diaphragm up and
    encroach on the lung
    Paroxysmal Nocturnal
    dyspnea
    “ Attacks of severe dyspnea occurring at
    night and waking the patient up from sleep”

    Mechanism: Same mechanism +


    1. Sliding down from semi-sitting position after
    falling asleep
    2. Blunting of respiratory and cough center
    response during sleep allows pulmonary
    congestion to accumulate
    3. Bad dreams increase the heart rate and blood
    pressure
    Haemoptysis
    “ coughing of blood”

    Cardiovascular causes:
     Mitral valve disease (due to pulmonary

    congestion)
     Acute left ventricular failure ( pulmonary oedema)

     Pulmonary infarction ( pulmonary embolism)


    Palpitation

    ”Awareness of heart beats “

    :Mechanism

    Increased force of cardiac contraction-


    Change in the heart rate-
    Change in the rhythm-
    Chest pain
    A. Cardiac causes:

    1. Ischaemia

    2. Pericardial pain

    3. Great vessel pain


    1. ISCHEMIC CHEST PAIN

    Atherosclerosis of coronaries is the most common


    cause
    Ischemic chest pain may be due to:

    1. ANGINA PECTORIS: transient myocardial ischemia


    during exercise. The coronaries are only partly
    occluded

    2. UNSTABLE ANGINA: Prolonged severe myocardial


    ischemia with or without patches of necrosis

    3. MYOCARDIAL INFARCTION: Complete arterial


    occlusion with myocardial tissue necrosis
    ANGINA PECTORIS
     CHARACTER:
     Dull aching, squeezing, compressing or burning. Never
    stitching or throbbing

     SITE:
     Mostly retrosternal, usually radiates to left arm
     Sometimes may spread to root of neck, both shoulders and
    arms, back, epigastrium or jaw.
     Not under left breast.

     RELIEVING FACTORS:
     Relieved by rest-after 1-3 min and by sublingual nitroglycerin
     PRECIPITATING FACTORS:
     Exertion
     Emotion
     Heavy meals
     Exposure to cold
     Sexual intercourse

     ASSOCIATED MANIFESTATIONS:
     Sweating
     Tachycardia
     Anxiety
     Rise in blood pressure
    MYOCARDIAL INFARCTION

     Pain is identical with that of angina in


    character, site and radiation but is much
    more severe and prolonged and is not
    relieved by rest or sublingual nitroglycerin

     May be accompanied by vomiting and


    sense of impending death
    2. Pericardial pain:

     Site: to the left of the sternum overlying


    the heart, may radiate to shoulder or
    neck
     Character: sharp and cutting
     Constant or made worse by sudden
    movement
     Worse on lying back, eased by leaning
    forward
     Increased by coughing, swallowing or
    inspiration
    3. Great vessels pain:

     Aneurysm of the aorta

     Dissecting aneurysm in the aorta

     Pulmonary embolism
     B-NON CARDIAC CAUSES:

    1. Pain from chest wall


    2. Pain from lungs, pleura or
    mediastinum
    3. Pain from abdominal causes
    How these symptoms occur:

    1. Manifestations of the cause as chest pain in IHD

    2. Manifestations of pulmonary congestion

    3. Manifestations of low cardiac output


    Manifestations of pulmonary
    congestion

     Causes of pulmonary congestion

    * Left heart failure due to :


    - Valvular disease (AS – AR – MR)
    - Hypertension
    - IHD
    - Cardiomyopathy

    * Mitral stenosis
    Effects of left ventricular failure leading to
    congestive heart failure
    1. There is increased LVEDP  increased LAP 
    increased pulmonary venous and capillary pressure 
    interstitial edema

    2. The lungs are overfilled, stiff, difficult to distend


    leading to dyspnea, orthopnea and PND

    3. Dyspnea also results from reflexes initiated from the


    stiff lungs and distended left atrium
    4. Transudation of small amount of serum
    in the alveoli makes the alveolar wall
    sticky and their inflation with inspiration
    produces fine crepitations

    5. With severe congestion the alveoli


    become filled with transudate resulting in
    pulmonary edema
     In pulmonary edema there is severe dyspnea,
    cyanosis, cough with expectoration of large
    amount of frothy sputum tinged with blood

     The flow of air in the fluid produces bubbling


    crepitations heard all over the chest

     Some distended pulmonary and bronchial veins


    and capillaries may rupture and release blood in
    the alveoli and bronchi causing haemoptysis
     Congestion of bronchial mucosa increases
    the secretion of mucus which is
    expectorated as white or colorless sputum

     Congestion of the visceral pleura may


    result in pleural effusion
     Pulmonary vessels react to congestion by
    arteriolar vasoconstriction

     Blood flow from pulmonary arteries to


    pulmonary veins will be limited by the
    resistance of the arterioles leading to:

     Decrease in severity of pulmonary


    congestion and relief of its symptoms
     Increase in the pressure in the pulmonary
    arteries  Pulmonary Hypertension
     Right ventricular hypertrophy and failure
    may result
    Low cardiac output
     Causes:
     Resistance to cardiac emptying:
    1. Severe valvular stenosis
    2. Severe pulmonary hypertension

     Incomplete cardiac filling:


    1. External compression limiting diastolic filling:
    massive pericardial effusion
    2. Limitation of diastolic filling by severe tachycardia
    3. Reduction of venous return by dehydration
    Clinical features of low COP
     Symptoms
     Easy fatigability
     Dizziness, blurring of vision, syncope
     Angina
     Signs
     Small volume of pulse
     Sinus tachycardia
     Peripheral cyanosis
     Cold extremities
     Pallor
     Oliguria

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