45 Differential Diagnosis for PT: Hematological, Cardiovascular, Immune, and Digestive System Disorders: Summary
Symptoms of Heart Failure Right-Sided Heart Failure • Dyspnea • Hypotension • Weakness • Peripheral edema • Poor exercise tolerance • Tachycardia • Pallor
Left-Sided Heart Failure • Hypertension • Pulmonary congestion • SOB • Weakness • Poor exercise tolerance • Tachycardia • Pallor
Endocarditis An infection of endocardium or heart valves hich can damage or destroy valves • Signs/symptoms: Fever and chills are the most common symptoms ○ Anorexia, weight loss, malaise, headache, myalgias, night sweats, SOB, cough, and joint pains are common complaints Pericarditis Inflammation of the lining of heart • Causes: Infection, kidney failure, metastatic disease, some medications, and radiation therapy • Recent viral infection often precedes pericarditis in young, otherwise healthy patients • In idiopathic pericarditis, no clear cause is determined • Signs and symptoms: The most common symptom is sharp, stabbing chest pain behind the breastbone or in the left side of the chest. Pain can be dull, achy, or pressure- like instead and of varying intensity. ○ Pain may travel into left shoulder and neck ○ SOB when reclining ○ Tachycardia ○ Low-grade fever ○ An overall sense of weakness, fatigue, or malaise Mitral Valve Prolapse (MVP) Malfunction where flaps moves back into atrium when the heart beats • This can let blood flow from the ventricle back into the atrium
• Signs and symptoms: racing heart or skipping beats, occasional chest pain, SOB, dizziness, anxiety or panic • Unknown etiology; 1 in 20 individuals are born with MVP • More common in females Peripheral Vascular Disease (PVD) Abnormality in arteries/veins outside of heart • Most common sites are abdominal aorta and iliac arteries • May impair muscle activity and sensation in legs • Leads to necrosis, ulcers, and gangrene • Signs and symptoms, increasing fatigue/ weakness in lower extremities, intermittent claudication, sensory impairment, weak peripheral pulses, pallor, cyanosis with extremity elevated, rubor with dependence, dry, hairless appearance Ankle–Brachial Index (ABI) Assessment • Systolic blood pressure ankle divided by systolic BP arm • Normal value: 0.90 to 1.3 • Normally, systolic pressure in the legs is 10% to 20% higher than in the arms • Peripheral artery disease: 1.0 or below Vascular Claudication During treadmill walking test, look for the following signs and symptoms: • Pain increases with activity • Halts with rest, even standing • Neurogenic: Impacted by position change regardless of exercise
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