The Cardiac Exam: History Taking

Introduction

As with any part of the physical exam, a complete cardiac exam should begin with a detailed cardiac history.  A good historian should be able to predict the physical exam findings before attempting the actual physical exam.  A thorough cardiac history should include investigating for the following cardiac (8) symptoms, as well as general cardiac heart: Tip: Think Cx2DEFx2GHI (Chest pain, Cyanosis, Dyspnea, Edema, Fainting, Fatigue, General, Hemoptysis, Irregular heart beat)

Questions for each symptom should cover the 7 classic dimensions of directed history taking:

  1.     quality (q1)
  2.     quantity (q2)
  3.     aggravating (alleviating) factors (af)
  4.     time course (t)
  5.     location (l)
  6.     associated symptoms (as)
  7.     setting (s)
Tip: Think Qx2ATLAS (Quality, Quantity, Aggravating/Alleviating factors, Time course, Location, Associated symptoms, Setting)

A sample list of relative questions pertaining to each symptom (including question category) is shown below.

Chest Pain

Cyanosis (bluish color skin)

Dyspnea (shortness of breath)

Edema (dependent)

Fainting (syncope)

Fatigue

General

Hemoptysis (coughing up blood)

Irregular Heart Beat


Please feel free to make suggestions of additional questions you typically ask during your history through the comments page.

(14 February 2000)
david.kaelber@case.edu-- Copyright 1999-2000-- Unauthorized use prohibited