Now let’s look at symptoms you could expect to find on a cardiac patient:
- Dyspnea – Could be continuous or intermittent, exertional (increases with exertion) or non-exertional, or orthopneic (dyspnea when sitting or standing). Paroxysmal Nocturnal Dyspnea (PND) is a condition where patients’ with congestive heart failure begin to have problems breathing after lying flat for some time.
- Coughing – Coughing can be something or nothing. A ‘cardiac cough’ could be dry, productive, frothy, bloody. Coughing indicates the patient might mean that his/her pulmonary circulation is congested with higher than normal volumes or pressures.
- Altered levels of consciousness – If caused by a possible cardiac etiology, alterations in levels of consciousness are usually related to a decrease in cardiac output. A decrease in cardiac output can be caused by hypovolemia (anything that decreases) arrhythmia, \
- Evidence of sympathetic nervous system stimulation – Diaphoresis, restlessness, anxiety, feeling of impending doom, nausea/ vomiting
- Fatigue
- Palpitations – the patient tells you that they feel a fluttering in their chest
- Edema – Edema is swelling. The swelling will occur where gravity overcomes the tendency of the circulatory system to move blood. This can occur in the extremities or sacral. When looking at bedridden patients, it may be better to look for ‘dependent edema’, which would be anywhere edema would collect (could be on the back of legs and arms depending upon condition and position of patient).
- Headache – Occurs as a result of increased systolic blood pressure (a reflex of the vascular system when it discovers a blockage of some sort is to increase the blood pressure to the point the obstruction is blown away).
- Syncope – Occurs as a result of decreased systolic blood pressure
- Behavioral changes, anguished facial expression, and activity limitations
- Trauma – Trauma secondary to cardiac conditions happens more often than you think. Anytime you respond to a fall or any other singular incident with insignificant mechanism, always try to rule out a medical cause. Changes in systolic blood pressure can make the patient clumsy and prone to falls.
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