Symptoms of heart disease

During the examination of patients can be obtained very important data on the etiology, nature and duration of heart disease. These include: Argyll Robertson pupil, splenomegalia, diffuse goiter, a kidney, congenital anomalies, abnormal venous pulsation in the neck or precordial, cyanosis, and edema  fingers. Careful palpation can detect and hypertrophy of the right or left ventricle, or diastolic movements tril. 

Edema

In the examination of patients in outpatient clinics can detect edema or lower limb joints as well as edema in the area of ​​the sacrum, glutel area and rear areas in inpatients.

The mere presence of edema is not sufficient for the diagnosis of patients suffering from heart failure, in addition to complaining more and dyspnea. Edema are often expressed in obese patients and in those with insufficient leg veins and thrombophlebitis after izlečenog. There are other non-cardiac causes of edema as wearing garters, stockings or elastic cuff deflation, followed by prolonged sitting or standing, fluid retention before menstruation, as well as idiopathic edema in women. Can lead to edema d nephrosis and nephritis terminal, cirrhosis with ascites, congenital and acquired lymphatic edema hypoproteinemia, expressed starvation and anemia, as well as obstruction of veins inferior coffee.


Cyanosis

Cyanosis may be central or peripheral. Central type of cyanosis caused by low arterial oxygen saturation caused by intracardiac desnolevim SANTO due to arteriovenous fistula in the pulmonary circulation, certain chronic lung disease, or due to pneumonia. And unlike peripheral cyanosis is expressed in the mucous membranes of warm-for instance. on the inside of the lips, the tongue and conjunctiva. Proves the determination of the partial pressure of oxygen (PO2) in arterial oxygen saturation and the system.Polycythemia vera can lead to the onset of cyanosis of central type despite normal oxygen saturation as a large number of red blood cells increases the amount of reduced hemoglobin. In order to differentiate cyanosis caused by a shunt in the heart or lungs than that caused by primary lung disease, it is useful to prescribe 100% oxygen. Oxygen has no effect on the cyanosis caused by Santa, but cyanosis will disappear if it is parenchymal lung disease.

And if saturaoija normal arterial oxygen may be a peripheral cyanosis. Appears in cold parts of the body such as the fingertips, nose, ears and cheeks. It is caused by slow circulation in the peripheral vascular system causing the capillary flow releases more oxygen than normal. And some diseases such as pulmonary stenosis Mitri stenosis or heart failure may lead to a reduced "cardiac output" and peripheral cyanosis. However, the most common causes of the tension of the nervous system that is associated with cold, cold hands and overall body exposure to cold.

Noises, sounds and popping sounds weak

Auscultation is possible to determine the presence of structural and functional abnormalities. This is achieved by noting changes in the first and second heart sounds, the presence of an extra heart sounds, ekstrakardijalnih sounds, noises and systolic pulmonary artery and high-pitched sound of the aorta in systole. It is also necessary to distinguish the sounds which have no known pathological features. These include: torn and normal tone, high systolic sound, III normal tone, and noise cardiorespiratory functional heart murmurs. In some cases it is very difficult to correctly interpret the appearance of noise, such as. pronounced in the case of heart failure with a very small "Cardiac Output" or in the case of pronounced ventricular tachycardia. Compensatory condition or reduction of ventricular tachycardia can cause low-intensity sounds clear. Thus, for example. you can hear the noises that they previously could not detect. Based on volume, the sound is divided by degrees of I-VI, where I denotes the number of noise at the lowest intensity, and VI of the strongest.

A. Systolic murmurs: short and soft systolic murmur may be functional, especially if there are no other changes, and if significant changes in respiration and changes in patient position. Fatigue and tachycardia increase the intensity of each forest. So called. functional systolic murmur meets the mitral and pulmonary mouth and he crescendodecrescendo guy who ends before systole and refers to the flow of blood from the right or left vcntrikla in pulmonary artery or aorta. Best heard in lean people. At full inspiration can be lost or reduced in intensity, while providing full expiration can significantly reinforce CATIA. Clear systolic murmur is probably essentially organic. Each systolic murmur, which was monitored and Trillo over a region of valvular disease in favor of valves, unless it comes to extreme anemia, Pansistolni noise that can be heard at the top of the heart, usually regurgitirajućeg character and result of changes in mitral valves. Propagates toward the left axilla or interscapular region and its character is organic. Systolic murmur over the aorta is transferred to the carotid artery or the upper interscapular region when it comes to organic changes in the aortic valves or aortic dilatation base. This noise is often heard well at the top of the heart.

B. Diastolic murmur: diastolic murmurs may be due to dilatation of the heart (acute myocarditis, severe anemia), dilation of aortic rings (pronounced hypertension), heart valves or deformation due to intracardiac shunts. In order to detect diastolic murmur attention needs to focus on dijastolu.

Of the authors:
Dr. Henry Brainerd, professor of medicine
Dr. Marcus A. Krupp, Professor of Medicine
Dr. Milton J. Chatton, Professor of Medicine
Dr. Sheldon Margen, professor of medicine

Article:
Dr. Maurice Sokolow
Dr. Ernest Jewetz