1. Chest paindiscomfort
2. Dyspnoea
3. Palpitations
4. Fatigue
5. Syncopedizziness
6. Intermittent claudication
7. Ankle swelling
8. Past medicalsurgical history
9. Familysocialdrug history
10. Systems

Chest paindiscomfort

• SOCRATES.
• Onset: recent pattern changes.
• Character: dull discomfort (angina).
• Timing: at rest vs. exertionmeals (GERD).
• Exacerbating: inspirationmovement.
• Alleviating: sublingual nitratesleaning forward.

Dyspnoea

• Exertional: how far can you walk?
• Orthopnoea: sleep with pillows?
• Paroxysmal nocturnal dyspnoea: gasp at night?

Palpitations

• Ever unusually aware of heartbeat?
• SOCRATES.
• Onset: sudden vs. gradual.
• Timing: slow vs. fast.
• Timing: regular vs. irregular.
• Missed beat sensations.

Fatigue

• Change in fatigue levels.

Syncopedizziness

• SOCRATES.
• Onset: saw blood (vasovagal).
• Onset: stood up (HTN drugsangina drugs).
• Onset: felt it coming on.
• Conscious vs. unconscious.

Intermittent claudication

• Distance walked before leg pain.

Ankle swelling

• Symmetrical vs. asymmetrical.
• How far up leg.

Past medicalsurgical history

• MIangina.
• Rheumatic fever.
• HTNHTN of pregnancy.
• Congenital heart problems.
• STDsinfections.
• Dental work (S. viridans).
• Investigations: angiogram.
• Surgery: CABGtransplantvalve replacementangioplasty.

Family history

• Condition in a relativewhat age.
• MI.
• Angina.
• Congenital heart dz.
• Mitral valve prolapse.
• Marfan's.
• DM.
• HTN.

Social history

• Smoking: ever smokedhow many per dayfor how longtype [cigarettepipechew].
• Alcohol (hypercholesteremia risk).
• Occupation: stresswork interruption.
• Activity levels.
• High cholesterol diet.
• See Atherosclerosis RiskFactors Reference.
• Describe your home: stairsetc.
• Who is with you there at home [help if MIhelp with tasks].

Drug history

• HRT.
• Thyroid drugs.
• Diabetic drugs.
• Prostate dz drugs.
• Steroids.
• Vasodilator (cause of ankle edema).
• Allergies.
• Allergies to drugsdyes.

Systems

• Pulmonary (dyspnea cause).
• Alimentary GERD (chest pain cause).
• Nervous (syncope cause).

Cardiovascular Exam »

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