Question 1

SHORTNESS OF BREATH - DYSPNEA

Accepted Answer

- Intense / Acute or sudden => consult an emergency doctor / Call 15 depending on symptoms
- Moderate and progressive => cardiological +/- pneumological assessment

Possible causes of dyspnea :
- Cardiac origin: pulmonary embolism, cardiac rhythm disorder, pericardial effusion, heart failure
- Extra-cardiac origin: pulmonary, laryngeal or tracheal infection or obstruction, pneumothorax, non-infectious pneumopathy, underlying asthma, chronic bronchitis, pleural effusion, lung damage, anemia ...

Question 2

CHEST PAIN

Accepted Answer

- Intense / Acute or sudden => consult an emergency doctor / call 15 depending on symptoms +++.
- In non-emergency cases => cardiological +/- pulmonary work-up

Possible causes of chest pain :
- Cardiac/vascular origin: pulmonary embolism, cardiac rhythm disorder, pericardial effusion, heart failure, infarction, angina, aortic dissection, hypertensive crisis
- Non-cardiac origin: pulmonary infection, pleural effusion, pneumothorax, acute pancreatitis, gastro-duodenal ulcer, cholecystitis, musculoskeletal pain ...

Question 3

PALPITATIONS

Accepted Answer

- Extrasystole: sensation of a jolt, extra beat, stronger beat or cardiac pause
- Sustained tachycardia or arrhythmia: sensation of heart beating faster (> 100 bpm) and/or irregularly.

If symptoms are intense and prolonged, or associated with other cardiac symptoms => consult an emergency physician / call 15 according to symptoms

In all other cases: cardiological assessment

Possible causes of tachycardia or cardiac arrhythmia: underlying heart disease, acute infarction, rhythmic disease, metabolic deficiencies, anemia, hyperthyroidism, inappropriate sinus tachycardia, etc.

Question 4

DISEASE: SYNCOPE or LIPOTHYMIA

Accepted Answer

- Syncope: sudden loss of consciousness with no warning signs => consult an emergency physician / call 15 depending on symptoms
- Lipothymia: sensation of impending unconsciousness, sweating, dizziness, blurred vision, ringing in the ears, but without total loss of consciousness => consult an emergency physician / call 15 according to symptoms.

- Lipothymia may be followed by syncope, or be isolated.
- Syncope may be preceded by lipothymia, or may be isolated.

The causes of syncope and lipothymia can be the same, they require a cardiological workup.

Possible causes :
- Cardiac conduction disorder
- Cardiac rhythm disorder
- Cardiac obstruction (valvular stenosis, obstructive heart disease, pulmonary embolism, severe pericardial effusion / tamponade , pulmonary hypertension ...)

The most frequent cause is vagal +/- related to orthostatic hypotension.

All in all, any acute, intense or sudden symptom requires urgent treatment. Once an emergency has been ruled out, a cardiological work-up is recommended.

SYMPTOMS

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