CARDIOVASCLILAR SYSTEM ANATOMY OF THE CONDUCTION SYSTEM
S
CHEST PAIN e
cardiac pain central tight or heavy; may
radiate tothejawor ATRIA
>
- :
,
is
>
-
pleuropericardial pain worse : when pt lies . m
sharp ,
associated with dyspnea 3 fever V
-
>
-
to determine the cause of chest pain :
ascertain the
-
duration AV
-
location >
Node
-
quality J
-
precipitating
aggrevating factors 3
H is Bundle
relief3 accompanying symptoms
-
> Cardias
transplant (denervated) pts diabetics (neuropathy) tend to
-
Left Bundle
present wh no or little pain or dullness 7
> TYPICAL PRESENTATION ↳
Branch
ANGINA precipitated by physical/emotional Right
-
exertion Ventricle T
Right Bundle
>
-
chasking/crushing/heaviness/poking/discomfort type of pain -
improved by rest , nitrates or both
Branch
often dull s in perceived pain
↳
Left Anterior
>
aching character may not be as lasts less than 10 minutes ~
-
-
Septum
-
>
-
radiates to the
jam Fascicle
>
-
severity varies
>
-
retrosternal (central) , throat = location
stable pain execution
>
-
angina :
on L
> unstable angina :
pain at rest do awakes pt from sleep
-
.
Often able that Left Posterior
>
-
pts .
to predict the extent of exertion produces pain
> pain relieved by rest or nitrates
fascicle
PRESENTATION OF VARIANT ANGINA
-
>
>
-
change in onset pattern time's response
, to rest or nitrates are L
serious in a pt WI known stable argina
(PRINIMENTAL'S ANGINA)
.
Left
argina Pectoris that is Ventricle
-
usually secondary to a large vessel 7
spasm ,
3 is sharacterized by discomfort at rest' ST
Segment elevation during the attack
~
ATYPICAL TYPES OF STABLE ANGINA -
belief is prompt after the administration of nitrates
-
nocturnal argina -> occurs It night
crescendo
-
angina
>
-
↑ art in frequency
>
-
w/ time chronic ischemic area may become infracted
singing decubitus
ACLITE MYOCARDIAL INFARCTION
-
-occurs spantaneously at rest but does not persist ,
if
persistent consider AMI/HA -
2/3 of pts present wh
. some sort of symptoms days or even weeks before the event
3 neck
V
-
deep retrosternal
, ,
visceral pain described as aching or
crushing wh radiation to the Larm , jaw
lasts than 30 min
langer
PRESENTATION OF UNSTABLE ANGINA
-
slassical from
-
ACS presentation ,
in its most severe
-
characterized by a progressive 4 in arginal symptoms new onset ,
of at rest or nocturnal argina or prolonged symptoms (does not
dissipate wl rests
-
precipitated by an acute rupture of a plaque wl platelet adhesion
-
but incomplete luminal obstruction
symptoms are more intense sompared to argina CHEST WALL PAIN ASSOCIATED SIGNS
-
30 % pts Will
of . suffer a M1 within 3 months of onset -
sirgues against (AD/Angina 3 AMI -
general "unwell" appearance
these pts Gre high risk I could to infarct at any point localized to of the chest
progress an small area wall nausea ' vomiting
- -
. -
-
ECG shanges is an NB marker for progression to AMI -
associated to breathing /arm or shoulder movement -
dyspue a
-
sharp pain -
anxiety restlessness
-
very short duration , or persistent over long periods -
Agnor animi/impending slaam)
-
associated bx of injury cough etc . , ,
-
dizziness, lightheadedness ,
OTHER DIFFERENTIALS FOR CHEST (ceovical/thoracis)
-
referred pain from spinal injury or disease synsope
pale complexion
-
PAIN diaphoresis
-
-
massive pulmonary embolism
-
dissectingaortic aneurysm
-
spontaneous Pneumothorax
-
gastro-oesophageal reflux/spasm
-
shole systitis
S
CHEST PAIN e
cardiac pain central tight or heavy; may
radiate tothejawor ATRIA
>
- :
,
is
>
-
pleuropericardial pain worse : when pt lies . m
sharp ,
associated with dyspnea 3 fever V
-
>
-
to determine the cause of chest pain :
ascertain the
-
duration AV
-
location >
Node
-
quality J
-
precipitating
aggrevating factors 3
H is Bundle
relief3 accompanying symptoms
-
> Cardias
transplant (denervated) pts diabetics (neuropathy) tend to
-
Left Bundle
present wh no or little pain or dullness 7
> TYPICAL PRESENTATION ↳
Branch
ANGINA precipitated by physical/emotional Right
-
exertion Ventricle T
Right Bundle
>
-
chasking/crushing/heaviness/poking/discomfort type of pain -
improved by rest , nitrates or both
Branch
often dull s in perceived pain
↳
Left Anterior
>
aching character may not be as lasts less than 10 minutes ~
-
-
Septum
-
>
-
radiates to the
jam Fascicle
>
-
severity varies
>
-
retrosternal (central) , throat = location
stable pain execution
>
-
angina :
on L
> unstable angina :
pain at rest do awakes pt from sleep
-
.
Often able that Left Posterior
>
-
pts .
to predict the extent of exertion produces pain
> pain relieved by rest or nitrates
fascicle
PRESENTATION OF VARIANT ANGINA
-
>
>
-
change in onset pattern time's response
, to rest or nitrates are L
serious in a pt WI known stable argina
(PRINIMENTAL'S ANGINA)
.
Left
argina Pectoris that is Ventricle
-
usually secondary to a large vessel 7
spasm ,
3 is sharacterized by discomfort at rest' ST
Segment elevation during the attack
~
ATYPICAL TYPES OF STABLE ANGINA -
belief is prompt after the administration of nitrates
-
nocturnal argina -> occurs It night
crescendo
-
angina
>
-
↑ art in frequency
>
-
w/ time chronic ischemic area may become infracted
singing decubitus
ACLITE MYOCARDIAL INFARCTION
-
-occurs spantaneously at rest but does not persist ,
if
persistent consider AMI/HA -
2/3 of pts present wh
. some sort of symptoms days or even weeks before the event
3 neck
V
-
deep retrosternal
, ,
visceral pain described as aching or
crushing wh radiation to the Larm , jaw
lasts than 30 min
langer
PRESENTATION OF UNSTABLE ANGINA
-
slassical from
-
ACS presentation ,
in its most severe
-
characterized by a progressive 4 in arginal symptoms new onset ,
of at rest or nocturnal argina or prolonged symptoms (does not
dissipate wl rests
-
precipitated by an acute rupture of a plaque wl platelet adhesion
-
but incomplete luminal obstruction
symptoms are more intense sompared to argina CHEST WALL PAIN ASSOCIATED SIGNS
-
30 % pts Will
of . suffer a M1 within 3 months of onset -
sirgues against (AD/Angina 3 AMI -
general "unwell" appearance
these pts Gre high risk I could to infarct at any point localized to of the chest
progress an small area wall nausea ' vomiting
- -
. -
-
ECG shanges is an NB marker for progression to AMI -
associated to breathing /arm or shoulder movement -
dyspue a
-
sharp pain -
anxiety restlessness
-
very short duration , or persistent over long periods -
Agnor animi/impending slaam)
-
associated bx of injury cough etc . , ,
-
dizziness, lightheadedness ,
OTHER DIFFERENTIALS FOR CHEST (ceovical/thoracis)
-
referred pain from spinal injury or disease synsope
pale complexion
-
PAIN diaphoresis
-
-
massive pulmonary embolism
-
dissectingaortic aneurysm
-
spontaneous Pneumothorax
-
gastro-oesophageal reflux/spasm
-
shole systitis
