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III. CVS Diseases – Clinical Manifestations

Diseases of the heart may manifest as both symptoms relating directly to the heart; regional or systemic symptoms. Here is a brief outline of an approach to understanding the clinical manifestations.

You will learn about this in detail from clinical examination texts such as Talley and O’Connor.

  • Localized symptoms directly from cardiac pathology
    • Chest pain, the nature of which is clinically important
    •    Egs of some conditions
      • Ischaemia
      • Pericarditis
    • Palpitations (eg. arrhythmias)
  • Symptoms arising in other organs.
    • Renal induced water retention; renal impairment or failure
    • Brain – cerebrovascular accident (infarct, haemorrhagic stroke – seen in poorly controlled hypertension or thromboembolism from atheromatous changes in carotid artery branches); hypertensive encephalopathy
    • Lower limbs – peripheral vascular disease eg. lower limb pain on walking etc. (This is seen in patients with atheromatous changes and thromboembolic complications in the vessels supplying the lower limbs)
  • Systemic symptoms
    • Eg. Heart failure
      • Systemic venous congestion
        • Body cavity effusions, lower limb swelling, etc.
      • Symptoms arising from pulmonary congestion and oedema (in left heart failure)
        • Dyspnoea and some specific types of dyspnoea; cough (read up on these)
    • Fatigue, dizziness, cool extremities
    • Collapse from cardiogenic shock (eg. acute myocardial infarction, sudden cardiac death etc
    • Cyanosis
  • Symptoms related to infections
    • High fever – eg. infective endocarditis

 

  • Symptoms of aortic disease (thoracic, abdominal)
    • Severe pain radiating to back, shock and rapid mortality – eg. aortic dissection or rupture of aneurysm

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