循环系统障碍Common_symptoms_and_signs_of_circulation_system

1、Common symptoms and signs of circulation system,Common symptoms of heart disease,Chest Pain,Dyspnea,Palpitation,Edema,Syncope,Cyanosis,Common symptoms of heart diseasechest pain,AP AMI Acute pericarditis Cardiac neurosis,Cause:,cardiogenic：,other,1, location,Common symptoms of heart diseasechest pai

2、n,keypoints of inquiry,2, nature and degree,3, duration,4, incentive,5, reliever,6, radiation,7, accompanied symptoms,Cardiac factors: cardiac dysfunction, pericardial tamponade, etc.,Common symptoms of heart diseasedyspnea,Cause,Non-cardiac factors: disease of respiratory system, disease of blood s

3、ystem, etc.,Others:,1, acute or chronic 2, relationship with position and movement 3, accompanied symptoms,Common symptoms of heart diseasedyspnea,keypoints of inquiry,heartthrob enhance arrhythmia tachycardia bradycardia arrhythmia cardiac neurosis,Common symptoms of heart diseasePalpitation,Common

4、 cause:,1, precipitating factor 2, accompanied symptoms 3, primary disease,Common symptoms of heart diseasePalpitation,keypoints of inquiry,Cardiogenic Cardiac output block Arrhythmia,Common symptoms of heart diseasesyncope,Other,Cause,1, Attack position 2, Precipitating factor 3, Symptoms before th

5、e attack 4, Accompanied symptoms,Common symptoms of heart diseasesyncope,keypoints of inquiry,Cardiogenic factors: cardiac dysfunction pulmonary embolism, etc,Common symptoms of heart diseasecough,Cause,Non-cardiogenic factors: respiratory system disease central cough,Cause Systemic edema cardiac ne

6、phrogenic hepatic Other reasons,Common symptoms of heart diseaseedema,Local edema Local inflammation Venous reflux obstruction, etc,1,Past history 2,Starting position 3,Accompanied symptoms,Common symptoms of heart diseaseedema,Keypoints of inquiry,Cause: Central cyanosis: cardiovascular pulmonary,C

7、ommon symptoms of heart diseasecyanosis,Peripheral cyanosis: Relative increase of peripheral oxygen consumption Arterial ischemia,Mixed cyanosis: Cardiac dysfunction Abnormal hemoglobin derivant,1,Onset age 2,Heart and lung disease history 3,Accompanied symptoms,Keypoints of inquiry,Common symptoms

8、of heart diseasecyanosis,Ventricular enlargement signs Heart rate and rhythm change Heart sound change Heart murmur Other important signs,Heart sign,Left ventricular enlargement,Apex pulse:,Left ventricular enlargement,lower-left shift,greater than 2 cm,lifting type impulse,lower-left enlargement,Ap

9、ex pulse range:,The apex :,Cardiac dullness border:,Right ventricular enlargement,Apex pulse:,Right ventricular enlargement,left-shift,Precordium :,lifting type impulse,Subxyphoid apex pulse:,common in pulmonary emphysema with right ventricular enlargement,Protrusion of precordium:,onset during chil

10、dhood,Cardiac dullness border:,left enlargement,pear-shaped heart,boot-shaped heart,mitral (valve) stenosis,aortic insufficiency,hydropericardium,upright positin,lying position,Heart rate and rhythm change,Fast and regular: sinus tachycardia, paroxysmal tachycardia,Slow and regular: sinus bradycardi

11、a, conduction block of level III with escape rhythm,Arrhythmia: sinus arrhythmia, premature beat, conduction block above II, atrial fibrillation,S1,S2,left edge of sternum and apex region,bottom,normal,S1 enhance,S1 recede,S1 division,apex,apex,bottom,factors that affect S1,Integrity of atrioventric

12、ular valve Activity of atrioventricular valve Ventricular systolic rate(dp/dt),Mitral stenosis Tachycardia High CO,factors that enhance S1,Mitral valve insufficiency Atrioventricular block level I Myocardial damage,factors that weaken S1,factors that affect S2,Aortic and pulmonary artery pressure In

13、tegrity and elasticity of semilunar valve,P2 enhancement in: Pulmonary hypertension Pulmonary circulation congestion,factors that enhance S2,A2 enhancement in: Hypertension Aortic atherosclerosis,P2 weakened in pulmonary valve lesions A2 weakened in aortic lesions,factors that weaken S2,expiration,i

14、nspiration,general Splitting,fixed splitting,reversed splitting,1,2,1,A2P2,1,A2P2,1,A2P2,1,P2A2,1,2,Extral sound,gallop rhythm opening snap abnormal heart sounds after prosthetic valve replacement,gallop rhythm,mid-diastolic gallop presystolic gallop quadruple rhythm,opening snap,Meaning: mitral ste

15、nosis Mechanism,abnormal heart sounds after prosthetic valve replacement,speedy blood flow,stenosis of valve opening or blood vessel,relative stenosis caused by ventricular enlargement or large blood vessels dilation,valvular insufficiency,relative valvular insufficiency,shunt of large blood vessels

16、 or chambers of heart,intracardiac floaters,Heart murmurs mechanism,1.Blood flow speedy 2. Valvular lesions 3. Large blood vessels or cardiac enlargement 4. Shunt 5. Intracardiac floaters,listenning content of cardiac murmur,location time conduction of murmur tones of murmur loudness of murmur relat

17、ionship between murmur and breathing, position, movement or some drugs,Cardiac auscultation region,Systolic murmurs strength classification,Level 1: weak noise, a very short time, unheard during the first few seconds,Level 2: weak noise, more easily heard,Level 3: noise of medium intensity,Level 4:

18、a loud noise, often accompanied by tremor,Systolic murmurs strength classification,Level 5: very loud, shocking , unheard after taking stethoscope away from chest wall , all accompanied by tremor,Level 6: extremely loud, heard even with stethoscope a certain distance away from chest wall , with stro

19、ng tremor,cardiac murmur,mitral insufficiency,ventricular septal defect VSD,Aortic stenosis,pulmonary valve stenosis,aortic insufficiency,mitral (valve) stenosis,patent ductus arteriosus PDA,conduction of murmur tones of murmur relationship between murmur and breathing, position, movement,differenti

20、ation between physiological and pathological murmur,Pericardial rub,other important sighs,Tremor,Peripheral vascular signs,The clinical significance of various cardiac tremor,Peripheral vascular sign,Water hammer pulse Capillary pulsation Shooting sound,abnormal pulse,Water hammer pulse:,pulse rises

21、 rapidly, and suddenly falls, indicating pulse pressure increase，common in aortic incompetence.,Pulse deficit：,pulse rate slower than ventricular rate, indicating atrial fibrillation.,abnormal pulse,Paradoxical pulse:,Pulse weaken obviously or disappear during inspiration. Suggesting pericardial eff

22、usion or constrictive pericarditis (cp).,Pulsus alternans：,Rhythm is normal , strong and weak pulse appear alternately , serious myocardial damage performance.,Mitral stenosis,auscultation: S1 enhancement in apex, and late diastole rumbling murmur, most clear in left decubitus, P2 hyperfunction or d

23、ivision, valve openning tone,percussion: pear-shaped heart,palpation: diastolic fine tremor in apex area,Inspection: mitral valve face, apex impulse left- shift,Mitral insufficiency,auscultation: Apex rough blowing pansystolic murmurs, range is wide, conduct to left axillary or left shoulder angle,

24、conduction, S1 abate, P2 hyperfunction,percussion: left enlargement of cardiac dullness border,palpation: lifting type impulse of the apex,Inspection: apex impulse lower-left shift,Aortic stenosis AS,auscultation: A2 weaken or disappear, rough systolic murmur can be heard in aortic valve area, condu

25、cting to neck,Inspection: apex impulse lower-left shift,palpation: lifting type impulse of the apex,systolic tremor in aortic valve area,percussion: lower-left enlargement of cardiac dullness border,Aortic insufficiency,Auscultation: Apex S1 abate, A2 weaken or disappear, sighing diastolic murmur ca

26、n be heard in the second aortic auscultation area , conducting to the apex region,Inspection: apex impulse lower-left shift, range dispersed,Palpation: apex impulse lower-left shift, lifting type impulse of the apex,Percussion: lower-left enlargement of cardiac dullness border, boot-shaped heart,Per

27、ipheral vascular signs: capillary pulsation sign, water shock pulse, artery shooting tone,Ventricular septal defect VSD,Inspection: apex impulse normal or slight left shift,Palpation: systolic tremor can be heard in sternal left edge 3rd and 4th intercostal space,Percussion: cardiac dullness border normal or slight enlargement, slight cardiac waist bulging,Auscultation: rough systol