Major signs or symptoms suggestive of cardiovascular, pulmonary, or metabolic disease

Bilateral ankle edema that is most evident at night

A characteristic sign of heart failure or bilateral chronic venous insufficiency

Uncomfortable awareness of breathing should be regarded

Abnormal when it occurs at a level of exertion that is not expected to evoke this symptom in a given individual

The pain from intermittent claudication does

Become more severe when walking upstairs or uphill, and is often described as a cramp, which disappears within 1-2 minutes after stopping exercise

Patients with diabetes are at an increased risk for this condition

C.A.D.

Favoring an ischemic origin (Character, Location, Provoking factors)

Character: constricting, squeezing, burning, "heaviness," or "heavy feeling". Location: substernal, across midthroax, anteriorly; in one or both arms, shoulders; in neck, cheeks, teeth; in forearms, fingers in interscapular region. Provoking factors: exercise or exertion, excitement, other forms of stress, occurrence after meals.

Against an ischemic origin (Character, Location, Provoking factors)

Character: dull ache; "knifelike," sharp, stabbing; "jabs" aggravated by respiration. Location: in left submammary area; in left hemithorax. Provoking factors: after completion of exercise, provoked by a specific body motion.

Individuals with intermittent claudication are more prevalent to

Coronary artery disease

Syncope

Defined as a loss of consciousness

Dyspnea

Defined as an abnormally uncomfortable awareness of breathing

An abnormally uncomfortable awareness of breathing commonly occurs

During strenuous exertion in healthy, well-trained individuals and during moderate exertion in healthy, untrained individuals

Although some may be innocent, these may indicate valvular or other cardiovascular disease

Heart murmurs

High cardiac output AKA

Hyperkinetic

These are among the most common causes of exertion-related sudden cardiac death

Hypertrophic cardiomyopathy and aortic stenosis

Nocturnal dyspnea may occur

Individuals with chronic obstructive pulmonary disease

The pain that occurs in a muscle without an adequate blood supply (usually as a result of atherosclerosis) that is stressed by exercise

Intermittent claudication

Nocturnal dyspnea differs from paroxysmal nocturnal dyspnea

It is usually relieved after the individual relieves himself or herself of secretions rather than specifically by sitting up

Generalized edema

Known as anasarca, occurs in individuals with the nephrotic syndrome, severe heart failure, or hepatic cirrhosis

Both orthopnea and paroxysmal nocturnal dyspnea are symptoms

Left ventricular dysfunction

The pain from intermittent claudication does NOT

Occur with standing or sitting, and is reproducible from day to day

Pain; discomfort (or other anginal equivalent) in the chest, neck, jaw, arms, or other areas that may result from ischemia

One of the cardinal manifestations of cardiac disease, in particular coronary artery disease

Shortness of breath at rest or with mild exertion

One of the principal symptoms of cardiac and pulmonary disease

Defined as an unpleasant awareness of the forceful or rapid beating of the heart that may be induced by various disorders of cardiac rhythm

Palpitations

Prevention of the normal rise (or an actual fall) in cardiac output

Potentially life-threatening and include severe coronary artery disease, hypertrophic cardiomyopathy, aortic stenosis, and malignant ventricular dysrhythmias

Abnormal exertional dyspnea suggests

Presence of cardiopulmonary disorders, in particular left ventricular dysfunction or chronic obstructive pulmonary disease

Dizziness or syncope is most commonly caused

Reduced perfusion of the brain

Orthopnea

Refers to dyspnea occurring at rest in the recumbent position that is relieved promptly by sitting upright or standing

Paroxysmal nocturnal dyspnea

Refers to dyspnea, beginning usually 2-5 hours after the onset of sleep, which may be relieved by sitting on the side of the bed or getting out of bed

Dizziness and, in particular, syncope during exercise may

Result from cardiac disorders that prevent the normal rise (or an actual fall) in cardiac output

Unilateral edema of a limb

Results from venous thrombosis or lymphatic blockage in the limb

Dizziness or syncope shortly after cessation of exercise

Should not be ignored, the symptoms may occur even in healthy individuals as a result of a reduction in venous return to the heart

Various disorders of cardiac rhythm include

Tachycardia, bradycardia of sudden onset, ectopic beats, compensatory pauses, and accentuated stroke volume resulting from valvular regurgitation

Although there may be benign origins for these symptoms, they also may signal the onset of or change in the status of cardiovascular, pulmonary, or metabolic disease

Unusual fatigue or shortness of breath with usual activities

Palpitations also often result from

anxiety states and high cardiac output states, such as anemia, fever, thyrotoxicosis, arteriovenous fistula, and the so-called idiopathic hyperkinetic heart syndrome