Cardiac Diagnosis for Acute Care: The NP’s and PA’s Guide to a Comprehensive History and Deciphering the Differential

Description

Helps clinicians to systematically look beyond the obvious to arrive at a correct diagnosis Written specifically for both novice and experienced cardiovascular clinicians in acute care settings, this is the only resource to focus on the art of conducting an in-depth patient history. Too often, patients will tell their first provider one thing and their second provider another. Even when asked the exact same question, patients’ stories can inexplicably change. Clinicians can save time, effort, and cost by parsing out conflicting patient histories with a specific and detailed line of questioning. If recorded accurately and interpreted correctly, a comprehensive history alone may obtain a correct diagnosis without exhaustive and expensive evaluations. This book includes two clinical scenarios for chief complaints that cardiovascular clinicians may see in their practice. Unpacking these scenarios challenges clinicians to look beyond the obvious and recognize atypical presentations. Each scenario dissects then discusses the history and other pertinent patient information to illuminate subtle differences in the process of information gathering. With this breakdown, the clinician can then identify if the patient has an acute cardiovascular issue. Each chapter ends with a sample of “how to present the patient” to an MD or peer and describes common pitfalls and assumptions to avoid. Key Features: Focuses specifically on acute cardiovascular issues in acute care settings Referenced by chief complaint or consult questions Targets patient history portion of the workup Examines subtle differences between cardiac diagnosis versus noncardiac diagnosis based on how patient history is taken Highlights common errors in review of information using electronic medical records versus standard questioning Cover......Page 1 Title......Page 4 Copyright......Page 5 Contents......Page 8 Foreword......Page 10 Foreword......Page 12 Preface......Page 16 Introduction: Assessment, Diagnosis, and Patient History in Acute Cardiac Presentations......Page 18 Reference......Page 21 Share Cardiac Diagnosis for Acute Care: The NP’s and PA’s Guide to a Comprehensive History and Deciphering the Differential......Page 22 Part I: Common Presentations of Acute Cardiac Conditions......Page 23 Definition and Significance of Chest Pain......Page 25 History A......Page 26 History B......Page 27 Key Features of the History......Page 28 Key Features of the Data......Page 33 Differentials and Differences in Exam......Page 36 Pulling it all Together......Page 38 Summarizing the Scenario......Page 40 References......Page 41 Chapter 2: Chest Pain: Another Encounter......Page 43 History A......Page 45 History B......Page 48 Key Features of the History......Page 49 Key Features of the Data......Page 51 Differentials and Differences in Exam......Page 53 Pulling it all Together......Page 55 Summarizing the Scenario......Page 59 Common Pitfalls and Assumptions......Page 60 References......Page 62 Definition and Significance of Shortness of Breath......Page 63 History A......Page 64 History B......Page 65 Key Features of the History......Page 66 Key Features of the Data......Page 72 Differentials and Differences in Exam......Page 75 Pulling it all Together......Page 77 References......Page 82 Chapter 4: Shortness of Breath: Another Encounter......Page 85 History A......Page 87 Key Features of the History......Page 90 Key Features of the Data......Page 93 Differentials and Differences in Exam......Page 97 Pulling it all Together......Page 99 Summarizing the Scenario......Page 102 Common Pitfalls and Assumptions......Page 103 References......Page 104 Definition and Significance of Syncope......Page 107 History A......Page 108 History B......Page 110 Key Features of the History......Page 111 Key Features of the Data......Page 118 Differentials and Differences in Exam......Page 120 Pulling it all Together......Page 122 Summarizing the Scenario......Page 128 References......Page 130 Chapter 6: Syncope: Another Encounter......Page 133 History A......Page 135 History B......Page 138 Key Features of the History......Page 139 Key Features of the Data......Page 142 Differentials and Differences in Exam......Page 144 Pulling it all Together......Page 146 Summarizing the Scenario......Page 152 Common Pitfalls and Assumptions......Page 153 References......Page 154 Definition and Significance of Troponins......Page 157 Key Features of the Data......Page 162 Pulling it all Together......Page 163 Summarizing the Scenario......Page 165 References......Page 167 Chapter 8: Elevated Troponin: Another Encounter......Page 169 Key Features of the History......Page 171 Key Features of the Data......Page 172 Differentials and Differences in Exam......Page 173 Pulling it all Together......Page 174 Summarizing the Scenario......Page 176 Common Pitfalls and Assumptions......Page 177 References......Page 178 Part II: Uncommon Presentations of Acute Cardiac Conditions......Page 179 Definition and Significance of Fatigue......Page 181 History A......Page 184 History B......Page 188 Key Features of the History......Page 189 Key Features of the Data......Page 191 Differentials and Differences in Exam......Page 192 Pulling it all Together......Page 193 Summarizing the Scenario......Page 197 References......Page 198 Definition and Clinical Signficance of Cough......Page 201 History A......Page 204 Key Features of the History......Page 209 Key Features of the Data......Page 212 Differentials and Differences in Exam......Page 214 Putting it all Together......Page 215 Summarizing the Scenario......Page 219 References......Page 220 Definition and Clinical Significance of Abdominal Pain......Page 223 Key Features of the History......Page 229 Key Features of the Data......Page 232 Differentials and Differences in Exam......Page 233 Pulling it all Together......Page 235 Summarizing the Scenario......Page 239 References......Page 240 Part III: Summary and Useful Clinical Tools......Page 243 Chapter 12: Conclusion......Page 245 Chapter 13: Bonus Section: The Write-Up......Page 249 Index......Page 265