occurs when myocardial demand exceeds supply
substernal pain or intense pressure radiating to neck, jaws, arms, particularly left
SOB, fatigue, diaphoresis, faintness, syncope
no exam findings suggest angina
tachy, tachypnea, HTN, diaphoresis
ischemia may lead to crackles d/t pulmonary edema or reduction in S1 or an S4.
higher risk w/COPD, xanthelasma, HTN, PAD, murmurs
viral infection cause (echovirus or coxsackie)
cancer, HIV/AIDs, hypothyroid, renal failure, TB, rheumatic fever, kawasaki.
MI, heart surgery, meds (procainamide, hydralazine, phenytoin), radiation therapy to chest.
may cause pericardial effusion
sharp stabbing CP
pain worse w/coughing, swallowing, deep breathing, lying flat.
relieved by sitting up and forward
pain in back, neck, shoulder
SOB lying down
anxiety or fatigue
scratchy, grating, triphasic frction rub
easily heard left of sternum in 3rd and 4th intercostal space
constrains cardiac relaxation, impairing blood return to right heart
pericarditis, malignancy, aortic dissection, trauma
discomfort relieved when sitting forward
pale, gray, blue skin
swellling of abdomen or arms, neck veins
beck triad (JVD, hypotension, muffled heart sounds)
direct cytotoxic effect of secondary immune response
viral-enterovirus, coxsackie, influenza, etc.
Helminthic (trichinosis), Bites/stings, Amphetamines, systemic inflammatory disease, peripartum cardiomyopathy
initial sx vague
fatigue, dyspnea, fever, palpitations, history of flu like symptoms in last 1-2 weeks.
murmurs, gallop, tachycardia
pulsus alternans (alternation of strong and weak arterial pulse)