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)
  • Fatigue, dizziness, cool extremities
  • Collapse from cardiogenic shock (eg. acute myocardial infarction, sudden cardiac death etc
  • Cyanosis

• 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