histroy taking in cardiac cases
TRANSCRIPT
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History Takingin
Cardiac CasesShahid Abbas
Interventional cardiologist and Physician
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Introduction ?
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Introduction
Name
Age
Occupation
Residence
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Presenting Complaints
1 or 2
How to ask ?
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H/o present Illness
• How to start ?
• Detail of PC and all the pertaining IssuesMissed D/D
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Chest Pain ?
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Chest Pain• Intensity
• Pattern
• Location
• Duration
• Radiation
• Aggravating/ relieving F
• Frequency
• Progression
• D/D
• ACS
• Pneumonia
• PE
• Dissection of Aorta
• APD GERD
• Costochondritis
Associations
• Sweating
• Palpitations
• Fever
• Breathlessness
• vomiting
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Breathlessness ?
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Breathlessness• NYHA
• Orthopnia /PND (No of Pillows)
• Palpitations
• Oedema feet
• Abd Distension
• Otners
• Life style modification
• Fever
• Hemoptysis
• D/D
• LVF
• COAD/ Br Asthma
• Infections/TB
• PEmbolism
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Palpitation ?
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Palpitation• Frequency
• Rhythem
• Micturtion reflex
• DC cardioversion
• Embolic
• Drugs
• CVA
• Kid
• Gut
• Limb
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MI ?
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Risk Factors
• DM
• HTN
• Smoking
• Dyslipedemia
• Family History
• Menopause
CAD equivalents
• DM
• Abd Aortic aneurysm
• PVD
• Symptomatic Carotid Artery disease
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Cardinal points
• Dizziness Syncope
• CVA
• Carotid Artery Disease
• Chest Pain
• Breathlessness
• Palpitations
• MI
• Intermittent Claudication
• Oedema Feet
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Systemic review
Co-Morbidity
COAD
Br Astma
CLD
CKD
Contraindications to stenting
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Investigations
Results
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Treatment
Compliance
Response to medications
Side effects
Admissions
Drug Allergies
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Personal / family History
Exercise
Smoking
Alcohol
Marital Status
Kids
Socioeconomic Bracket
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Pace Makers
• Old Documents
• 1 Lead or 2 Leads
• Syncope
• Pus discharge from pocket - I/v Drugs Antibiotics
• Pace Maker follow up trouble shooting
• Threshold
• Sensing not possible in demand mode
• Anticoagulation (AF + Pacing)
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Pace Maker (Cont)
• Hysteresis
• Bipolar pacing
• Magnet VOO
• Over sensing/ under sensing
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VHD
Presenting Symptoms
• decompensation
First symptom
Breathlessness
• Orthopnia
• Life style modification
• Otners synd
• Wheeze
• Palpitation
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VHD (cont )
Chest Pain• Angina
• IHD risk Factor
Hemoptysis
• Fever
• Pulm oedema
• Chest Pain (infarction/ Embolism)
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VHD (cont )
IE• Fever duration response to Medications
• Admission
Thrombo-Embolism• Palpitations
• KID
• CVA
• Gut
• Limbs
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VHD (cont )
Progression of Disease
Rehumatic Fever Child hood• Sore throat
• Joint pains
• Monthly painful Inj
Admissions in the Past
Investigations• Xray Chest
• ECG, ECHO
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VHD (cont )
Treatment• Compliance
• Response
• Side effects
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Functional Disabilty
Class 0
Class I
ClassII
Class III
Class IV
• Transfer
• Dressing
• Wash room utility
• Ablation
• Eating
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Thank You