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The main symptoms and signs of common diseases of circulatory system

The main symptoms and signs of common diseases of circulatory system 1 st Affiliated Hospital Liaoning Medical College He Xin. 一、 Mitrial stenosis. 1 、 Causes: --- RHD:rheumatic heart disease ---CHD:congenital heart disease

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The main symptoms and signs of common diseases of circulatory system

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  1. The main symptoms and signs of common diseases of circulatory system 1st Affiliated Hospital Liaoning Medical College He Xin

  2. 一、Mitrial stenosis 1、Causes: ---RHD:rheumatic heart disease ---CHD:congenital heart disease ---Other reasons: senile retrograde

  3. 2、Symptoms ---cough ---hemoptysis ---dyspnea: dyspnea on exertion→ paroxysmal nocturnal dyspnea → pneumonedema

  4. 3、Signs: ---Inspection mitrial face Apex impulse may be displaced to the left ---Palpation diastolic thrill palpable over the apical area ---Percussion normal heart borders→pear shape heart

  5. ---Auscultation --the first sound (S1)↑ --diastolic murmur :apical area; localized; mild and latediastolic ; crescendo ; rumbling; more clearly when the patient is lying on his left side --opening snap may be auscultatory --accentuation of second pulmonary sound (P2↑), splitting --Graham Steel’s murmur (PV diastolic) --Maybe atrial fibrillation(late stage)

  6. 二、Mitral Insufficiency 1、Causes ---RHD / non-RHD ---acute/chronic 2、Symptoms ---fatigue ---palpitations ---dyspnea on exertion ---Left heart failure

  7. 3、Signs : ---Inspection apex beat is displaced downwards and to the left ---Palpitation --apical impulse forceful --Heaving apex impulse --Severe systolic thrill

  8. ---Percussion the area of dullness to left and downwards ---Auscultation --S1 ↓(attenuation) --murmurs: harsh; pansystolic murmur; blowing; 3/6 grade ↑ wide spread-transmitted to left axilla left infrascapularangle

  9. 三、Aortic Stenosis 1、Causes --- RHD ---Congenital ---Senile retrograde 2、Symptoms palpitation ,dizziness, angina pectoris, syncope, HF-dyspnea

  10. 3、Signs : ---Inspection --apical impulse increase --Displaced to left and downwards ---Palpation --apex beat is elevated and forceful --systolic thrill can be palpated over aortic auscultatory valve area --Pulse tardus

  11. ---Percussion the area of dullness is normal or to left and downward ---Auscultation --murmur aortic auscultatory valve area systolic murmur harsh ,ejection sound ,3/6 grade↑ (thrill)，transmitted to neck --A2 ↓,reversed splitting --S4

  12. 四、Aortic Insufficiency 1、Causes ---RHD ---Non-RHD：congenital prolapse syphilis aortitis arteriosclerosis endocarditis acute/chronic

  13. 2、Symptoms palpitation, dizziness, LHF 3、Signs ---Inspection apical impulse to left and downwards ---Palpation apex impulse to left and downwards Heaving apex impulse

  14. ---Percussion --the area of cardiac dullness is enlarged downwards and to the left --the concave part of the heart is not enlarged (boot shape)

  15. ---Auscultation --specific murmur diastolic sighing aortic area heard clearly sitting erect and forward --Austin Flint murmur relative MS (rumbling mid-diastolic murmur)

  16. ---Peripheral vascular signs*head bobbing (Musset’s sign):nodding motion of the head with each systole*signs of capillary pulsation*water hammer pulse*pistol shot sounds : esp. Femoral arteries*Duroziez’s murmur*Visible pulsation of carotid arteries

  17. 五、Pericardial effusion 1、Causes infective and non-infective pericarditis 2、Symptoms pain over the pericardial region Dyspnea, cough, fever, lassitudeShock

  18. 3、Signs : ---Inspection diminution in strength of the apex beat or absence of the apex beat jugular venous enlargement

  19. ---Palpation --diminution in strength of the apex --beat or the apex beat palpated uneasily paradoxical pulse may be present ---Percussion enlargement of the cardiac dullness bilaterally, changed with posture

  20. ---Auscultation --pericardial friction sound --HR↑,diminution of intensity of cardiac sound (S1/S2↓) --pericardial knock may be heard

  21. 4、Large effusion ---Jugular varicosity ---Liver enlargement ---Paradoxical pulse ---Pulse pressure ↓ ---Kussmaul sign ---Ewart sign

  22. ---Kussmaul sign deep inspiration –jugular vein distension ---Ewart sign: left infrascapular region vocal fremitus↑ dullness -- percussion bronchovesicular breath sound--auscultation

  23. 六、Heart Failure 1、Causes myopathy ; ventricular load ↑ promote factors

  24. 2、Symptoms ---LHF: fatigue, cough, frothy sputum dyspnea(on exertion → orthopnea → paroxysmal nocturnal ~) ---RHF: abdominal distension, oliguria, nausea, vomiting

  25. 3、Signs : LHF: ---Inspection : tachypnea , cyanosis, semireclining/sitting position Acute pneumoedema: frothy sputum, hyperhidrosis ---Palpation : pulse alternans ---Percussion : ---Auscultation :diastolic gallop rhythm P2↑ Fine rales, rhonchi

  26. RHF ---Inspection :Jugular distension Pericardial cyanosis Edema(pitting, pendulous) ---Palpation : liver enlargement, tenderness Hepatojugular reflux(+) ---Percussion : pleural effusion (right side) ascites ---Auscultation : RV diastolic gallop rhythm TV systolic blowing murmurs

  27. THANK YOU !

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