MAAS-MI Review of Systems

1HEART: Chest Pain

2HEART: Chest Pain / Palpitations

• 2.1Complaint Heuristic

  1. Asks whether the patient is aware of their heartbeat and what it is like;
  2. Asks whether during episodes of palpitations the heartbeat is slower or faster, regular or irregular, and whether the episodes stop suddenly or gradually;
  3. Asks about the nature of any palpitations (skipping, racing, fluttering, pounding, stopping).

• 2.2Time-Intensity Heuristic

  1. Asks how long the episodes last, how many hours a day;
  2. Asks about episodes over the last month.

• 2.3

• 2.4

• 2.5

3HEART: Chest Pain / Shortness of Breath

• 3.1Complaint Heuristic

  1. Asks whether breathing feels uncomfortable and requires effort during rest.

• 3.2Time-Intensity Heuristic

  1. Asks whether the dyspnoe:
     • Changes during the day;
     • Is getting worse during the night.
  2. Asks:
     • When the dyspnoe started;
     • How it changed over time.

• 3.3Triggering & Decreasing Factors Heuristic

  1. Asks whether the dyspnoe occurs when the patient is lying down and improves while sitting or standing;
  2. Asks how many pillows the patient uses to sleep comfortable;
  3. Asks whether the dyspnoe occurs during rest, during exercise or after exercise.

• 3.4Accompanying Complaints Heuristic

  1. Asks about accompanying symptoms: wheezing and coughing.

• 3.5

4HEART: Chest Pain / Peripheral Edema

• 4.1Complaint Heuristic

  1. Asks about swelling anywhere, in feet and legs, in vingers and hand, around the eyes, around the middle;
  2. Asks about tightness with shoes, rings, belts, and clothes.

• 4.2Time-Intensity Heuristic

  1. Asks whether the swelling is worse in the morning or at night.

• 4.3

• 4.4

• 4.5

5HEART: Chest Pain / Loss of Consiousness

• 5.1Complaint Heuristic

  1. Asks about any dizziness or loss of consciousness followed by recovery.

• 5.2Time-Intensity Heuristic

  1. Asks how long the episode lasted;
  2. Asks about the number of episodes in the last month.

• 5.3Triggering & Decreasing Factors Heuristic

  1. Asks whether the episode occurred with or after exercise.

• 5.4Accompanying Complaints Heuristics

  1. Asks about accompanying symptoms: chest pain, palpitations.

   

• 5.5

• 6.1References & Further Reading

  • Bickley, L., Szilagy, P., Hoffman, R., & Soriano, R. (2021). Bates’ Guide to physical examination and history-taking. Wolters Kluwer, Philadelphia
  • de Jongh, T., Schijf, V., van ’t Spijker, A., Pellikaan-van der Veer, M., 2019). Handbook History-taking (Leerboek Anamnese). Bohn, Stafleu, van Lochum, Houten.

• 6.2

• 6.3

• 6.4

• 6.5