This document provides guidance on how to conduct a thorough history taking for cardiac cases. It outlines the key areas of inquiry including: presenting complaints, history of present illness, risk factors, past medical history, family history, medications, lifestyle habits, functional status and expected diagnosis. For each complaint such as chest pain, breathlessness or palpitations, it lists the important questions to ask to fully characterize the symptom. The goal is to obtain a comprehensive history to inform the diagnosis and appropriate treatment plan.

1. History Taking
in
Cardiac Cases
Shahid Abbas
Interventional cardiologist and Physician

2. Introduction ?

3. Introduction
Name
Age
Occupation
Residence

4. Presenting Complaints
1 or 2
How to ask ?

5. H/o present Illness
• How to start ?
• Detail of PC and all the pertaining Issues
Missed D/D

6. Chest Pain ?

7. Chest Pain
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Intensity
Associations
Pattern
• Sweating
Location
• ACS
Duration
• Palpitations
• Pneumonia
Radiation
• Fever
• PE
Aggravating/ relieving F
• Breathlessness
• Dissection of Aorta
Frequency
• vomiting
• APD GERD
Progression
• Costochondritis
D/D

8. Breathlessness ?

9. Breathlessness
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NYHA
Orthopnia /PND (No of Pillows)
Palpitations
Oedema feet
Abd Distension
Otners
Life style modification
Fever
Hemoptysis
D/D
• LVF
• COAD/ Br
Asthma
• Infections/TB
• PEmbolism

10. Palpitation ?

11. Palpitation
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Frequency
Rhythem
Micturtion reflex
DC cardioversion
Embolic
Drugs
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CVA
Kid
Gut
Limb

12. MI ?

13. H/o MI
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DDT
SK
Door to Needle/ balloon time
DC Shock
LV dysfunction
Shock
Rehabilitation
TLC
Education

15. Risk Factors
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DM
HTN
Smoking
Dyslipedemia
Family History
Menopause
CAD
equivalents
• DM
• Abd Aortic
aneurysm
• PVD
• Symptomatic
Carotid Artery
disease

16. Cardinal points
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Dizziness Syncope
CVA
Carotid Artery Disease
Chest Pain
Breathlessness
Palpitations
MI
Intermittent Claudication
Oedema Feet

17. Systemic review
Co-Morbidity
COAD
Br Astma
CLD
CKD
Contraindications to stenting

18. Investigations
Results

19. Treatment
Compliance
Response to medications
Side effects
Admissions
Drug Allergies

20. Personal / family History
Exercise
Smoking
Alcohol
Marital Status
Kids
Socioeconomic Bracket

21. Pace Makers
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Old Documents
1 Lead or 2 Leads
Syncope
Pus discharge from pocket - I/v Drugs Antibiotics
Pace Maker follow up trouble shooting
Threshold
Sensing not possible in demand mode
Anticoagulation (AF + Pacing)

22. Pace Maker (Cont)
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Hysteresis
Bipolar pacing
Magnet VOO
Over sensing/ under sensing

23. VHD
Presenting Symptoms
• decompensation
First symptom
Breathlessness
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Orthopnia
Life style modification
Otners synd
Wheeze
Palpitation

24. VHD (cont )
Chest Pain
• Angina
• IHD risk Factor
Hemoptysis
• Fever
• Pulm oedema
• Chest Pain (infarction/ Embolism)

25. VHD (cont )
IE
• Fever duration response to Medications
• Admission
Thrombo-Embolism
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Palpitations
KID
CVA
Gut
Limbs

26. VHD (cont )
Progression of Disease
Rehumatic Fever Child hood
• Sore throat
• Joint pains
• Monthly painful Inj
Admissions in the Past
Investigations
• Xray Chest
• ECG, ECHO

27. VHD (cont )
Treatment
• Compliance
• Response
• Side effects

28. Diagnosis Expected
Patient is a case of Coronary Artery Disease having
RATAFICATION
Angina CCS II and breathlessness NYHA Class II
SIR
With no clinical evidence of LV de-compensation
IHD ka Case ha
And has Functional disability Class II/IV
Meriting Coronary evaluation and possible
Intervention

29. Diagnosis Expected
Patient is a case RATAFICATION
of Post Rehumatic Mitral Valve
Disease with predominant Mitral Stenosis
SIR
complicated by severe Pulmonary hypertension;
RHD ha sath MS aur AR ha
In Sinus rhythm With compensated heart with no
clinical stigmata of Infective endocarditis
And has Functional disability Class II/IV

30. Diagnosis Expected
Patient is a case of Post Rehumatic Mitral Valve
Disease with predominant Mitral Stenosis
complicated by severe Pulmonary hypertension;
Decompensated by Atrial Fibrillation but there are no
clinical stigmata of Infective endocarditis
And has Functional disability Class III/IV
Meriting intervention

31. Functional Disabilty
Class 0
Class I
ClassII
Class III
Class IV
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Transfer
Dressing
Wash room utility
Ablation
Eating

32. Thank You