PACES Approaches Ep3:Cardiology Approaches
In this informative content, explore the causes and system conditions related to chest pain, palpitations, hypertension, and lower limb swelling. Understand life-threatening causes of chest pain, such as ACS and aortic dissection, and delve into different cardiovascular, respiratory, GI, and musculocutaneous conditions that can manifest as chest pain. Learn about palpitations stemming from cardiac, structural, and extracardiac issues, and discover the various etiologies of hypertension, including renal, endocrine, neurogenic, and aortic factors. Furthermore, uncover the differential causes of lower limb swelling, from bilateral fluid overload to systemic and local pathologies.
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Presentation Transcript
PACES Approaches Ep3: Cardiology Approaches
Content Chest Pain Palpitations Hypertension Lower Limb Swelling
Chest Pain Life threatening causes: ACS, Aortic Dissection, Pulmonary Embolism, Esophageal Rupture, Tension Pneumothorax PACES Cases: Aortic dissection (Marfan s), pulmonary embolism (hypercoagulable state),
Chest Pain System Conditions Cardiovascular: Exertional ACS (Vasculitis) Dissection (Marfan s) Pericarditis (SLE, uremia, post-infectious) Anemia Respiratory: Cough, SOB Pneumothorax Most respiratory diseases can cause pleuritic chest pain GIT: Swallowing association, other GI symptoms Esophagitis Candidiasis (HIV) GERD/ulcer Esophageal rupture Musculocutaneous: Movement, touch Costochondritis Zoster
Palpitations Cardiac: Conduction Problems: Prolonged QTc, Brugada, WPW Structural Problems: HOCM, valvular pathology Extracardiac: Endocrine: Thyroid disease, pheochromocytoma Sinus Tachycardia: Many systemic pathologies But consider anemia, pulmonary embolism, drugs (sympathomimetics) For AF, consider valvular heart disease and thyroid disease
Hypertension Renal: Glomerulonephritis, renal artery stenosis, scleroderma renal crisis Endocrine: Grave s, Cushing s, Acromegaly, Conn s, Pheochromocytoma (MEN, NF, VHL) Neurogenic: Cushing s Reflex Aortic: Coarctation of aorta (NF), Vasculitis Labile: White coat Others: Pregnancy (pre-eclampsia), OSA (a/w acromegaly, hypothyroidism, Down s syndrome), Drugs
Lower Limb Swelling Bilateral Fluid Overload : Intra (cardiac, renal) vs Extravascular (hypoalbuminemia nephrotic syndrome + scleroderma renal crisis, chronic liver disease, protein losing enteropathy, malignancy) Systemic: Thyroid (Pretibial myxedema, edema from hypothyroidism), drugs (calcium channel blockers) Local: CVI, lymphedema, pelvic mass compression Unilateral: Vein (DVT), soft tissue (cellulitis, haeamtoma), joint (arthritis), bone (bone tumours)
Lower Limb Swelling Nephrotic Syndrome Primary DM and obesity Infection: Hep B/C, HIV, parainfectious Autoimmune: SLE Paraproteinemia: Multiple Myeloma Malignancy: Association with membranous nephropathy Drugs: NSAIDs, penicillamine, gold, captopril
