Cardiovascular History
3
Cardiovascular History Check name & DOB Presenting Complaint Chest pain Site – cardiac pain is not very localised normally – more diffused – if exact point can be pointed to then think respiratory problem Onset – over a while/sudden Character –crushing, pressing, burning, heavy, tight dull etc. – use patients own words – sharp is not common for cardiac pain Radiation – neck, jaw, L arm (MI), maybe R shoulder Associated symptoms – sweating? Difficulty breathing? Nausea? Vomiting? Palpations? Collapse? Pale? Clammy? Timing – linked to onset Exacerbating/relieving factors – exertion? At rest? When on painkillers? GTN – known heart disease? Severity – on a scale of 1 -10 Have they had this experience before? Evolution of symptoms? Shortness of Breath How long has this been going on for? Have you found it to be getting worse over this time? On a scale of 1 -10 how bad do you think it is? Is it affecting your daily living? Make I up a flight of stairs? Is there anything which makes it worse? o Exertion – how far- flight of stairs? Affecting activities of daily living? Affecting sleeping? Is there anything which makes it better? o Sitting down? Inhaler? Ankle oedema/swelling When did you first notice this? Has it got worse since you first noticed it?
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Transcript of Cardiovascular History
Cardiovascular History Check name & DOB
Presenting Complaint
Chest pain
Site – cardiac pain is not very localised normally – more diffused – if exact point can be pointed to then think respiratory problem
Onset – over a while/sudden Character –crushing, pressing, burning, heavy, tight dull etc. – use patients
own words – sharp is not common for cardiac pain Radiation – neck, jaw, L arm (MI), maybe R shoulder Associated symptoms – sweating? Difficulty breathing? Nausea? Vomiting?
Palpations? Collapse? Pale? Clammy? Timing – linked to onset Exacerbating/relieving factors – exertion? At rest? When on painkillers? GTN
– known heart disease? Severity – on a scale of 1 -10 Have they had this experience before? Evolution of symptoms?
Shortness of Breath
How long has this been going on for? Have you found it to be getting worse over this time? On a scale of 1 -10 how bad do you think it is? Is it affecting your daily living? Make I up a flight of stairs? Is there anything which makes it worse?
o Exertion – how far- flight of stairs? Affecting activities of daily living? Affecting sleeping?
Is there anything which makes it better?o Sitting down? Inhaler?
Ankle oedema/swelling
When did you first notice this? Has it got worse since you first noticed it? Unilateral/bilateral? Worse on one leg? Pain with it? If recent onset, long haul flights? (DVT) Chest pain with this (DVT PE)
Fainting/dizziness/blackout
How frequently do you faint? How long do the dizzy spells last for? Can you think of any trigger factor?
Palpations
How frequently do you get them? How long do they last? Does anything make them worse/better?
o Exertion/Sitting down Have you experienced them before? Affecting your daily living?
Sign post for other cardinal symptoms as patient may not be expecting them as they may not make the link. Don’t forget to screen for any other problems affecting you just now?
Past Medical History
Heart problems? Hypertension? High cholesterol? Diabetes?
Drug history
Aspirin – anti-platelet Beta-blockers Statins ACEi Digoxin
Family History
Heart problems? What age did they pass at? Arrhythmias can be inherited
Social History
Smoking Stress Occupation Live with? Alcohol consumption Exercise? – Sedentary lifestyle? Diet
Allergies
Systemic Enquiry
Respiratory GU MSK – localised chest pain tends to be MSK Neuro
