1. EPIDEMIOLOGY OF CVD (Cardiovascular Disease)
- CVD = No.1 cause of death worldwide
(30% of deaths).
- More
common in high-income countries (40%) than in low/middle-income
(28%).
Mnemonic: "CVD =
30-40-28"
- 30% of global
deaths
- 40% in
high-income
- 28% in
low/middle-income
2. EVALUATION OF A CVS
PATIENT
HISTORY – Symptoms &
risk factors
CLINICAL EXAMINATION –
BP, pulse, heart sounds
INVESTIGATIONS:
- Basic Tests:
ECG, Chest X-ray
- Advanced Tests:
ECHO, Stress Test, Holter Monitor, Angiography
Mnemonic:
"H.C.I." (History - Clinical - Investigation)
- History
- Clinical
Examination
- Investigations
3. IMPORTANT CVS
SYMPTOMS & THEIR MEANINGS
1. DYSPNOEA
(Breathlessness) - Types
• Grade I - No breathlessness on ordinary work
• Grade II - Breathlessness on ordinary work
• Grade III - Breathlessness on less than ordinary
work
• Grade IV - Breathlessness at
rest
Mnemonic:
"DOE: 1-2-3-4"
- Dyspnoea
- Ordinary
work (triggers)
- Exertion
(gets worse)
- 1-2-3-4
(NYHA classification)
Other Types of
Dyspnoea
- Orthopnoea
– Breathlessness while lying down, relieved by sitting.
- Paroxysmal Nocturnal Dyspnoea (PND)
– Sudden breathlessness at night.
- Acute Pulmonary Edema
– Breathlessness with pink frothy sputum.
2. COUGH & OEDEMA
- Cardiac Cough:
Dry & worse at night.
- Oedema:
Swelling in legs, generalized in severe cases.
Mnemonic:
"CHF = Cough + Swelling"
- Congestive
- Heart
- Failure
3. RIGHT UPPER ABDOMEN
PAIN
- Due
to liver congestion in right heart failure.
Mnemonic:
"RHF = Right Hepatic Failure"
4. OLIGURIA &
NOCTURIA
- Oliguria (↓ Urine output)
– Due to poor kidney perfusion.
- Nocturia (Night urination)
– Due to fluid redistribution at night.
Mnemonic:
"O.N. = Output Night"
5. PALPITATIONS
(Feeling of Heartbeat)
Causes:
- Fast heartbeat
(Tachycardia)
- Arrhythmias
- Heart failure
Mnemonic:
"PALPITATE = Pulse And Lively Palpitations In Tachycardia &
Arrhythmias"
6. CHEST PAIN (Angina
vs. MI)
- Stable Angina
– Pain on exertion, relieved by rest/Nitroglycerin.
- Unstable Angina
– Pain at rest, not relieved by rest.
- Myocardial Infarction (MI)
– Severe, prolonged pain with sweating, nausea.
Mnemonic:
"A-M-I"
- Angina –
Temporary
- Myocardial
Infarction – Permanent Damage
- Ischemia (reduced
blood supply)
7. SYNCOPE (Fainting)
- Due to ↓ blood flow to the brain.
- Common
causes: Arrhythmia, Hypotension, Aortic Stenosis.
Mnemonic:
"SYNCOPE = Sudden Yawning, Numbness, Collapse, Oxygen Poor
Environment"
8. CYANOSIS (Bluish
Skin)
- Peripheral Cyanosis
– Fingers, toes, cold hands (Low cardiac output).
- Central Cyanosis
– Lips, tongue, warm hands (Lung or heart defects).
- Differential Cyanosis
– Only lower limbs (Patent Ductus Arteriosus).
Mnemonic:
"C.P.D." (Cyanosis = Peripheral, Central, Differential)
9. SQUATTING
- Seen in congenital heart disease
(Tetralogy of Fallot)
- Why? Squatting
increases oxygenation by improving blood flow to the
lungs.
Mnemonic:
"Tetra Kids Squat" (Tetralogy of Fallot kids squat to relieve
cyanosis)
4. CVS MURMURS (Heart
Sounds)
Systolic Murmurs:
- Pansystolic – Mitral Regurgitation (MR), Tricuspid Regurgitation (TR)
- Ejection Murmur – Aortic Stenosis (AS), Pulmonary Stenosis (PS)
Diastolic Murmurs:
- Early Diastolic – Aortic Regurgitation (AR), Pulmonary Regurgitation (PR)
- Mid Diastolic – Mitral Stenosis (MS), Tricuspid Stenosis (TS)
Mnemonic:
"MR. AS, MS. AR" (Systolic & Diastolic Murmurs)
- MR AS → Mitral
Regurgitation, Aortic Stenosis (Systolic)
- MS AR → Mitral
Stenosis, Aortic Regurgitation (Diastolic)
5. CHEST X-RAY
FINDINGS IN CVS
• Right border: SVC, Right Atrium (RA),
IVC
Left border:
Aortic Knob (AK), Pulmonary Artery (PA), Left Atrium (LA), Left
Ventricle (LV)
Mnemonic:
"SVC-RA-IVC & AK-PA-LA-LV" (Chest X-ray borders)
CONCLUSION
- Remember:
CVS symptoms help in diagnosing different heart conditions.
- Use mnemonics to recall symptoms &
signs easily.
Quick Revision
Mnemonics:
CVD Deaths = "30-40-28"
Dyspnoea = "DOE 1-2-3-4"
CHF = "Cough + Swelling"
Angina vs. MI = "A-M-I"
Cyanosis Types = "C.P.D."
Murmurs = "MR. AS, MS. AR"
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PRACTICE OF MEDICINE