No indication is specific for heart disease, the assessment depends on
the entire clinical picture and in some cases depending on the
diagnostic tests
The common symptoms
Shortness of breath
Shortness of breath is the onset or worsening caused by stress and pressure left atrium and pulmonary veins or hypoxia.
Increased left atrial pressure and pulmonary veins are the most common
dysfunction of left ventricular diastolic (by hypertrophy, fibrosis or
pericardial disease) or valve obstruction caused. Phase onset or worsening of left atrial pressure can lead to pulmonary edema. Reduced blood ooxxy may be due to pulmonary edema or flow in the heart.
Shortness of breath should be determined by the level of activity is causing it.
Shortness of breath is a common symptom of lung disease and is
difficult to distinguish the pathogenesis, shortness of breath can occur
in people less or fat people, people in a state of anxiety, anemia and
diseases other.
Shortness of breath when lying is due to the increase in central blood volume. Shortness of breath when lying may also result from exposure of the lung and causes fat.
Paroxysmal dyspnea night will be mitigated by sitting or standing up, the symptoms are usually more specific in the heart.
Chest pain
Chest pain can occur due to a lung disease or bone disease, diseases of
the esophagus or gastrointestinal disease, stimulatory nerve roots
chest, or anxiety as well as cardiovascular causes.
The most common cause of chest pain due to heart the local myocardial ischemia.
The pain is often described as dull, aching or like feeling squeezed
in, tighten, tighten or stuffy than stabbing pain or cramps again, and
it is often perceived as an uneasy feeling more the pain. Ischemic pain usually fades within 30 minutes, but it could be longer.
The pain usually lasts corresponding myocardial infarction, pain is often accompanied by feeling restless or nervous. Location pain behind the breastbone usually in the front or left heart.
Although the pain may spread to either localized in the throat, jaw,
shoulder, hand in hand, upper abdomen or back, but it almost is included
under the sternum.
Ischemic pain is usually caused by exertion, cold temperatures, after
meals, stress, or a combination of these factors promote and usually
decreases with rest. The pain is not related to posture or breathing and often do not appear to touch the chest. In myocardial infarction, a motivating factor is usually not noticeable roc.
Left ventricular hypertrophy or aortic valve disease may also arise due to ischemic pain or pain at more typical. Myocarditis, cardiomyopathy and mitral sa often associated with atypical chest pain. Pericarditis can cause pain, but it varies according to posture and breathing. Aortic aneurysm causing tearing chest pain as a sudden and often spreads to the back.
Palpitations, lightheadedness and fainting
Realizing the heartbeat can be a normal phenomenon or may reflect
increased cardiac output, stroke or cardiac output increased in patients
with pericardial disease status (stress, thyrotoxicosis, anemia ,
anxiety ...).
It can also be due to cardiovascular disease increases stroke volume
(cardiac valve insufficiency, bradycardia) or may be a sign of cardiac
arrhythmias. Ventricular may be left ventricular beats as exotic or shy shy leapfrogging. Paroxysmal supraventricular tachycardia or ventricular patient can feel the beat or vibrate very fast, irregular or uneven. However, many patients do not see anything out.
If an irregular heartbeat combination significantly reduced blood
pressure and cardiac output, it can, especially upright, affecting blood
flow to the brain, causing dizziness, blurred vision, loss of
consciousness (syncope) or other symptoms.
The most common cardiac syncope due to sinus node stops or blocks the
way to the sinus node, atrioventricular block, or ventricular
tachycardia or ventricular fibrillation. Syncope may have some signs of the prodrome and can cause injury.
The absence of warning symptoms that distinguish cardiac syncope (Con
Adams - Stokes) with syncope due to the vagus nerve circuit, hypotension
posture or seizures. Although injured recover soon, some patients may have moves like in seizures.
Aortic valve disease and obstructive hypertrophic heart disease can
also cause fainting and often occurs after exertion or stress.
A different form of consciousness is the subject attracted considerable
attention in recent years is called neuropathic faint of heart.
In this syndrome have an increased inappropriate activities vagus
centrifugation, often due to increased stimulation of cardiac
sympathetic nerve before. But it can happen suddenly just like fainting due to cardiac arrhythmias.
Consistent
The cumulative translation first appeared under the skin in the lower
extremities in patients walk or sacral region of the bedridden. In heart disease, edema due to increased right atrial pressure caused. Heart failure is most often due to left heart failure despite signs of heart failure may be more pronounced card.
The other causes of heart failure include compliance pericardial
disease, valvular heart disease and cardiac right chronic lung.
Compliance may also be due to venous insufficiency, nephrotic syndrome,
cirrhosis or fluid retention before menstruation or it may be
idiopathic. Severe right heart failure may cause ascites, and almost always accompanied by consistent.
Functional classification of heart disease
The classification system of the New York Heart Association is usually applied.
The signs of heart disease
Although cardiovascular examination streamlined to focus on the heart, but the peripheral signals are also important.
Expression
While the patient looks healthy heart at rest, many patients with acute
myocardial infarction appear in anxiety and restlessness.
Sweating proven to lower blood pressure or condition agonists, such as
in acute myocardial molding, rapid arrhythmia or myocardial infarction.
The patients with severe congestive heart failure or delay prolonged low cardiac output may appear cachexia.
Purple may be due to loss of central arterial saturation or peripheral
lesions reflects the distribution of blood to the organization are fully
saturated in low cardiac output state, polycythemia or vasospasm
foreign marginal. Purple may be due to central lung, heart failure or left-right shunt - induced left. Purple due to shunt - left not improved with increasing concentrations of inhaled oxygen.
Often prove pale anemic but may be signs of low cardiac output.
Signs of life
Although the normal heart rate varied from 50-100 times / min, the
slower or faster pace may occur in the normal state or reflect the
pericardium as anxiety, pain, drug effects, thyroid disease, lung
disease or anemia hypovolemia.
If symptoms or clinical suspicion is confirmed, should record the ECG
to diagnose arrhythmias, conduction disturbances or other disorders.
Limit normotensive wide, but even in those without symptoms need
further evaluation and monitoring of these people as systolic blood
pressure less than 90 mmHg or above 140 mmHg and diastolic blood
pressure over 90 mmHg. Initially, blood pressure may be reduced if the patient is relaxed and resting comfortably.
Difficulty breathing fast but also nonspecific lung disease and heart
failure should be considered as respiratory frequency exceeds 16 times /
minute under normal conditions. Breathing cycle (Cheynes- Stokes type) rarely seen in severe heart failure.
Peripheral arteries and veins of the dam
Often due to decreased peripheral vascular disease peripheral atherosclerosis caused and may include localized beat. Seeing pulse imbalances should narrow waist suspected aortic that previous information can also be responsible.
This circuit can demonstrate strong all openings, narrow waist aorta,
patent ductus arteriosus or other conditions may increase stroke volume. Carotid valuable help assess left ventricular ejection.
Home narrow pulse slow and much slower (two DIN touchable) in narrow
openings owner and master mixes or disease obstructive hypertrophic
cardiomyopathy.
Paradoxical circuit (decrease in systolic blood pressure of 10 mmHg in
the inhaled) is valid for signs of heart pressed, although it also
occurs in asthma and chronic obstructive pulmonary disease.
Static opening scene dam allows insight into the left atrium.
It shows: 1. central venous pressure higher if more than 3 cm
vertically on the corner Louis, 2- central blood volume has increased
over 1cm higher if the term clicking on the right side for 30 seconds,
3. Congestion van 3 leaf veins or lungs if there are large waves cv. 3 leaves open the valve can be combined with liver dam.
Atrioventricular dissociation due to conduction block or ventricular
arrhythmias can be recognized when there is a wave cannon way back.
Check lung
Hear ran in the two bottom lungs are signs of heart failure, stasis, but also due to lung disease caused localized. Ran ran headlines and snoring proved obstructive pulmonary disease, but can also occur due to left heart failure. Pleural effusion with type two bottom perforated lung and alveolar whispering reduce heart failure are also common in stasis.
Pulse before the tim
The undulating edge memories often proves left ventricular hypertrophy,
pulmonary arterial hypertension (SBP> 50 mmHg) or to the left
atrium. The dam of pulmonary can see. Left ventricular apex impulse if prolonged and wide, showing hypertrophy or cardiac dysfunction. If it is clear, but not last, impulse tip can prove overload or high cardiac output. The beating heart in the front to add may reflect abnormal left ventricular contractility locally.
The heart sounds and murmurs
Listen to the heart may help diagnose or diagnosed heart disease, including heart failure.
English first heart can weak in left ventricular dysfunction severe mitral stenosis or strong or short PR. Second language is usually split into two parts (master before lung) and can analyze more pronounced in the inhaled.
The splitting of the second and more fixed in atrial septal, and broad
branch block and have lost or reversed (Paradoxical splitting) in a
narrow host, left ventricular failure or left branch block. With the splitting of normal, strong component P2 is important signs of pulmonary arterial hypertension.
English and fourth Tuesday of heart (ventricular and atrial rhythm
galloping respectively) demonstrated increased ventricular volume load
or the policy of relaxing vulnerable and can be heard in the language
either in ventricular apex S3 is a sign normal performance in young
people and pregnant women. Other signs include hiss hearing chord classified as high-clac hours.
They may be known first and corresponding systolic ejection sound (such
as aortic valve two-piece or pulmonary valve stenosis) or may occur
between end-systolic or show degenerative changes in the mucous van two
leaves.
While many systolic murmur proved valvular heart disease, a short
systolic murmur often localized along the left sternal or downward tip
may be harmless, reflecting increased pulmonary flow.
These murmurs are harmless (mechanical energy) vary with respiration,
decrease in the upright position and is often heard at the skinny.
Systolic murmur throughout systole and when they tied the first hour
and lasts throughout the entire systolic ejection murmur or when they
start after the first hour after hour and ended Monday with the
strongest peak in early or mid-systole.
Full systolic murmur met in open mitral if we listen to the maximum at
the tip or in the armpit and the tricuspid valve insufficiency or
ventricular septal if the next best memories audibly.
Murmur aortic systolic short with components A2 common in the elderly,
especially hypertension and even murmur to moderate them often reflects
van thick (fibrosis) than narrow. The combination of murmur with palpable vibration (vibration miu) always have clinical significance as a diastolic murmur.
Peripheral edema
Peripheral edema, especially when they appear on both sides and in combination with other symptoms, may indicate heart failure.
Other causes include disorders of the line periphery, liver, kidney and
thyroid, drug-induced accumulation of fluid retention (especially
blockers canci line or NSAIDs) or the effect of ostrogen.
