Car­diovascular (blood-circulation) system

Pains:

Localization (main site of pain) (precordial area, retrosternal — diffusive, localised).

Character (aching, shooting, stabbing, pinprick, sharp, dull, constricting (tight, heavy, crushing, pressing, like a weight, compressing, squeezing), burning, cutting, pinch, wasp, boring (gnawing), accompanying with a shiver, amplified hyperhidrosis, rapid imperative excessive urination, dyspnoea, sensation of melancholy, accompany by a sense of impending death, feeling of tightness, palpitation, intermissions, weakness, trembling in the body, cramps, filing of air deficit, dizziness).

Origin: gradually, in a moment, paroxysmal (attack-like).

Intensity (severity): mild, moderate, severe.

Duration (it may range from less than a second to several minutes, hours, days - steady).

Frequency (pain every day, several times a day (to indicate how many times), every week, seldom).

Periodicity (steady (constant), fluctuant, intermittent, transitory, attacks of pain); regular or irregular (pain-free) intervals of day, month.

Special time of occurrence

Radiation (to left shoulder, left arm, left shoulder-blade, left supraclavicular and infraclavicular region, the back, interscapular region, the left of the neck, lower jaw, the epigastric region, the right half of the chest).

Aggravating factors (provocation, the reason of occurrence,) (during insignificant physical exertion - during walk: quick, ordinary, slow; ascending the stairs, walking uphill (go upstairs), the other exercise stress (in considerable physical loading), excitement (emotional factors), frosty day, cold wind, excessive meal, after alcohol use, smoking, without visible cause).

Behaviour of the patient in pain (relieving conditions) subside spontaneously (stops: how many meters of way before stop, on what floor; how many minutes stand; lay in bed, rises, physical or emotional exertion, talking, try sitting, standing or walking; better itself feels in movement, changing position, etc.).

Relieving factors (relief with medication): the analgetic effect after intake of nitroglycerine (how many minutes pain persisting), how many tablets intakes a day, pain relieved at once, in few seconds, in few minutes; tolerance (well, noise in head).

Associated phenomena: pallor, sweating, vomiting.

Breathlessness (shortness of breath, dyspnoea): character (with difficulty of inhalation, an exhalation, mixed), intensity (dyspnoea on effort, go upstairs, fast walking, slow walking on plane surface, in rest). Onset of breathlessness (paroxysmal dyspnoea, asthmatic fit): in the afternoon after exercise stress, at night, duration, frequency, accompanied by the cough, bubbling breathing, discharge liquid pinkish foamy sputum, the position facilitating breathing during an attack.

Palpitations: awareness of the heart beat, unusual them frequency, begin gradually, suddenly, duration (how many minutes, hours), accompanied with a shiver, amplified hyperhidrosis, with rapid imperative urination; the reasons of occurrence (at exercise stress, fast change of position, excitement, in food intake, "causeless"), frequency of attacks, what stop they (reflex way, what medicine intake, call emergency)

Intermissions (escaped beats): periodic, constant, regular alternating (through 1-2, etc. of normal beat), chaotic, the reasons of occurrence (exercise stress, excitement, in food intake, lying position etc.).

Filling of a pulsation of neck vessels, head, top extremity etc., cold extremity, attacks numbness and paleness of hands and foots fingers, (symptom «dead fingers») on a cold.

Pains in gastrocnemius muscles at walking («an alternating lameness»), how many meters of way stops, how many minutes stand.

Oedema (swelling): localization (of feet, on the ankles, other parts of a body), degree of expressiveness (small, moderate, significant), changes within day (appear or increase by the end of day, decrease or disappear to the morning, do not change).

Дата добавления: 2015-11-16