From the Guidelines
When interviewing a patient from a cardiology standpoint, it is crucial to focus on a comprehensive cardiac history that includes chief complaint, history of present illness, past cardiac history, risk factors, and medication review, as emphasized by the ACC/AHA 2007 guidelines 1. This approach helps establish the cardiac diagnosis, assess disease severity, identify risk factors for progression, and guide appropriate management decisions.
Key Components of Cardiac History
- Primary symptoms:
- Chest pain (characterize by onset, location, radiation, quality, severity, timing, aggravating/alleviating factors, and associated symptoms)
- Shortness of breath (at rest or exertion, orthopnea, paroxysmal nocturnal dyspnea)
- Palpitations (regular/irregular, associated symptoms)
- Syncope or presyncope
- Edema
- Exercise tolerance
- Past cardiac conditions:
- Myocardial infarction
- Heart failure
- Arrhythmias
- Valvular disease
- Congenital heart disease
- Prior cardiac procedures or surgeries
- Previous cardiac testing results
- Risk factors:
- Hypertension
- Diabetes
- Dyslipidemia
- Smoking history
- Family history of premature coronary disease
- Obesity
- Sedentary lifestyle
- Medication review:
- Cardiac medications (antihypertensives, antiarrhythmics, anticoagulants, statins)
- Adherence
- Recent changes
Additional Considerations
- Social history:
- Alcohol intake
- Recreational drug use
- Occupational exposures
- Functional capacity:
- Assessment of daily activities
- Correlation with maximum oxygen uptake by treadmill testing, as noted in the ACC/AHA 2007 guidelines 1 The most recent and highest quality study, the ACC/AHA 2007 guidelines 1, provides a comprehensive framework for evaluating patients from a cardiology standpoint, emphasizing the importance of a thorough cardiac history and risk factor assessment.
Prioritizing Morbidity, Mortality, and Quality of Life
By focusing on these key components and considerations, healthcare providers can prioritize morbidity, mortality, and quality of life outcomes, as recommended by the ACC/AHA 2007 guidelines 1 and supported by subsequent updates, such as the 2009 ACCF/AHA focused update on perioperative beta blockade 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Cardiology Questions for Patients
When assessing a patient from a cardiology standpoint, the following questions can be asked:
- What is your medical history, including any previous heart conditions or cardiovascular events? 2
- Are you currently taking any medications, such as aspirin, beta-blockers, or lipid-lowering agents? 3, 4, 5
- Have you experienced any symptoms such as chest pain, shortness of breath, or fatigue? 2
- Do you have a family history of heart disease or cardiovascular conditions? 3
- What is your lifestyle like, including your diet, exercise habits, and smoking status? 3, 4
Medication-Related Questions
- Are you taking your medications as prescribed, and are you experiencing any side effects? 3, 4, 5
- Have you recently started or stopped taking any medications, including beta-blockers, aspirin, or statins? 3, 4, 5
- Are you aware of the importance of taking your medications as directed to reduce the risk of recurrent acute myocardial infarction? 3, 4
Risk Factor Assessment
- Do you have any underlying medical conditions, such as hypertension, diabetes, or high cholesterol, that may increase your risk of cardiovascular disease? 3, 4, 5
- Are you at risk for cardiovascular disease due to your age, sex, or family history? 3, 4, 5
- Have you recently experienced any stress or trauma that may have triggered a cardiovascular event? 2