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)
- Systemic venous congestion
- Fatigue, dizziness, cool extremities
- Collapse from cardiogenic shock (eg. acute myocardial infarction, sudden cardiac death etc
- Cyanosis
- Eg. Heart failure
- 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