Материал: Internal_diseases_propedeutics._Part_II._Diagnostics_of_cardiovascular_diseases

Federal budgetary educational establishment of higher education Ulyanovsk State University

The Institute of medicine, ecology and physical culture

Smirnova A.Yu., Gnoevykh V.V.

INTERNAL DISEASES PROPEDEUTICS

PART II

DIAGNOSTICS OF CARDIOVASCULAR DISEASES

Textbook of Medicine for medicine faculty students

Ulyanovsk, 2016

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УДК 811.11(075.8)

БКК 81.432.1-9я73

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Reviewers:

Savonenkova L.N. – MD, professor of Department of faculty therapy

Smirnova A.Yu., Gnoevykh V.V. Internal diseases propedeutics (Part II). Diagnostics of cardiovascular diseases: Textbook of Medicine for medicine faculty students/Ulyanovsk: Ulyanovsk State University, 2017.-96

This publication is the second part of “ Internal diseases propedeutics” , which main goal is the practical assistance for students in the development of the fundamentals of clinical diagnosis of diseases of the cardiovascular system. It contains a description of the main methods of laboratory and instrumental diagnostic tests of diseases of the cardiovascular system. The publication is illustrated with charts, drawings and tables. The textbook is intended for students of medical universities.

Smirnova A.Yu., Gnoevykh V.V., 2017

Ulyanovsk State University, 2017

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THE CONTENTS OF A TEXT BOOK

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QUESTIONING OF PATIENTS WITH CARDIOVASCULAR DISEASES.

Main complains of patients with cardiovascular diseases.

Cardinal symptoms of cardiac diseases are chest pain or discomfort, symptoms of heart failure: dyspnea, edema, fatigue, cough and hemoptysis, nocturia; palpitation, syncope.

Chest pain is a common presenting symptom of cardiovascular disease and must be characterized carefully. Chest pain may be cardiac (myocardial or pericardial) or noncardiac in etiology. Ischemic pain is usually of sudden onset, located centrally and stabbing or constricting; it may radiate to the left arm, occasionally to the right, into the neck and to the back. It may be brought on by exercise, emotion, fright or sexual intercourse. Angina pectoris usually lasts less than 30 minutes and may be relieved by rest or administration of nitrates. The pain of myocardial infarction usually lasts for more than 30 minutes, often as long as several hours.

Site

The pain of cardiac ischaemia (angina / acute myocardial infarction) is often felt centrally in the mid-sternal area, sometimes higher up across the chest, and occasionally it may be felt in the epigastric region or at

the back between the shoulder blades. The pain over the precordium or the one that a patient can localize with a finger is seldom cardiac.

Character

Classically, the pain is constricting, squeezing, crushing or pressing and the patient may clench the fist while describing the sensation. It can be numbing, stinging or burning but not sharp, stabbing or shooting. After the initial waxing it remains constant: brief, repetitive pains are not due to cardiac ischaemia.

Duration

The pain usually lasts for 2-3 minutes but sometimes may linger for 10-15 minutes. It is neither momentary nor lasts for hours. Recurrent episodes with increasing severity (crescendo/unstable angina) last longer than a few minutes, are easily provoked

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