E2: Cardiovascular

Question 1

I present with

• FEVER + JOINT PAIN
• Migratory arthralgia
• Subcut. nodules on extensor surfaces
• Sore throat
• Flat, painless skin rash
• Carditis
• Chorea
• Weakness, malaise, weightless, anorexia
• Acquired valvular disease

Who am I?

Answer 1

Rheumatic Fever

Question 2

I present with

• Easy/early fatigue
• Dyspnea/orthopnea/paroxysmal dyspnea
• Palpitations
• Chest pain
• Pitting edema
• Dizziness and syncope

Who am I?

Answer 2

Valvular Heart Disease

Question 3

Endocarditis can cause damage to which three valves?

Answer 3

• Aortic
• Tricuspid
• Mitral

Question 4

Endocarditis risk factors include:

Answer 4

• Congenital and degenerative heart disease
• Invasive diagnostic procedures
  High risk factors:
• Previous valvular damage
  
  • Injection drug users
  • Post-cardiac surgical presentations

Question 5

I present with

• Arthralgia
• Arthritis
• MSK symptoms/LBP/SIJ pain
• Myalgia
• Petechiae/splinter hemorrhage (nail beds)
• Constitutional symptoms (malaise, weakness, gen. unwell)
• Dyspnea, chest pain, cold and pain in extremities (cool to touch)

Who am I?

Answer 5

Endocarditis

Question 6

I present with

• Palpitations (sensations of fluttering, skipping, irregular beating or pounding, heaving action)
• Dyspnea
• Chest pain
• Anxiety
• Pallor, fatigue
• Dizziness, light-headedness, fainting
• Nervousness
• Cyanosis

who am I?

Answer 6

Fibrillation of Heart

Question 7

I present with

• Occipital headache
• Vertigo or lightheadedness
• Flushed face
• Spontaneous epistaxis
• Vision changes (blurred/narrowing)
• Nocturnal urinary frequency

who am I?

Answer 7

Hypertension

Question 8

I present with:

• Slurred speech, sudden difficulty with speech or difficulty understanding others
• Sudden confusion, loss of memory, even LOC
• Temporary blindness or dramatic visual changes
• Dizziness
• Sudden, severe headache
• Paralysis or extreme weakness (unilateral > bilateral)
• Difficulty walking, loss of balance or coordination
  My symptoms resolve within 24 hours max.

who am I?

Answer 8

TIA

Question 9

I present with

• ↓ in BP and ↑ in pulse
• Lightheadedness, dizziness
• Pallor, diaphoresis
• Syncope or fainting
• Mental or visual blurring, narrowing
• Sense of weakness or “rubbery” legs

who am I?

Answer 9

orthostatic hypotension

Question 10

Triggers for Raynaud’s include

Answer 10

• Cold temperature
• Strong Emotions

Question 11

I present with

• Cyanotic blue digits
• Pallor in digits (white)
• Intense redness of digits (proximal)
• Cold, numbness, pain of digits

who am I?

Answer 11

Raynaud’s Phenomenon

Question 12

A superficial venous thrombosis presents with:

Answer 12

• Subcutaneous venous distention
• Palpable cord
• Warmth, redness
• Indurated (hard)

Question 13

A DVT presents with

Answer 13

• Unilateral tenderness in leg (extremity)
• Unilateral swelling (>3cm difference in leg circumference)
• Warmth
• Discoloration
• Tenderness to palpation

Question 14

What tool is used to evaluate for the likelihood of a DVT?

Answer 14

Wells Criteria

Question 15

Risk Factors for a PE/DVT include:

Answer 15

• Previous personal/family history of thromboembolism
• Congestive heart failure
• Age >50 Y
• Oral contraceptive use
• Immobilization or inactivity
• Obstetric/gynecologic conditions
• Obesity
• Neoplasm
• Pacemaker
• Trauma (Recent surgical procedures, Indwelling central venous catheter, Fracture, Burns, Spinal cord injury, Endothelial injury,
• stroke
• Blood disorders
• History of infection, DM