Differential Diagnosis for Physical Therapy: Hematological, Cardiovascular, Immune, and Digestive System Disorders: Summary 121
in the lungs → pulmonary edema, which brings about SOB ○ Left-sided heart failure often leads to right-sided heart failure • Right-sided: Right ventricle cannot pump out enough blood → fluid gets backed up
in the veins and then in capillaries of the body → fluid leaks out of the capillaries and builds up in the tissues, a condition called systemic edema ○ Edema especially noticeable in lower extremities
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
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