Critical and Cardiac Care
T. Scott Gallacher, MD, MS
Critical Care History and Physical
Reason for admission to the ICU.
History of present illness:
This section should included
pertinent chronological events leading up to the hospi-
talization. It should include events during hospitaliza-
tion and eventual admission to the ICU.
Prior cardiac history:
Angina (stable, unstable, changes
in frequency), exacerbating factors (exertional, rest
angina). History of myocardial infarction, heart failure,
coronary artery bypass graft surgery, angioplasty.
Previous exercise treadmill testing, ECHO, ejection
fraction. Request old ECG, ECHO, impedance cardiog-
raphy, stress test results, and angiographic studies.
Chest pain characteristics:
Quality of pain, pressure, squeezing, tightness
B.Onset of pain:
Exertional, awakening from sleep,
relationship to activities of daily living (ADLs), such as
eating, walking, bathing, and grooming.
C.Severity and quality:
Pressure, tightness, sharp,
Arm, jaw, shoulder
Diaphoresis, dyspnea, back
pain, GI symptoms.
Minutes, hours, days.
hypercholesteremia, low HDL, hypertension, smoking,
previous coronary artery disease, family history of
arteriosclerosis (eg, myocardial infarction in males less
than 50 years old, stroke).
Congestive heart failure symptoms:
ber of pillows), paroxysmal nocturnal dyspnea,
dyspnea on exertional, edema.
Peripheral vascular disease symptoms
transient ischemic attack, cerebral vascular accident.