Chest pain :

• Acute, sudden, intense => call 15 / emergency consultation

• In non-emergency cases => cardiological assessment after referral by the attending physician to rule out any extracardiac cause

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Possible causes of chest pain :

• Cardiovascular origin: myocardial infarction/angina, pulmonary embolism, pericardial effusion, aortic dissection, cardiac rhythm disorder, etc.

• Non-cardiac origin: pneumological (pulmonary infection, pleural effusion, pneumothorax, etc.), digestive (acute pancreatitis, gastro-duodenal ulcer, cholecystitis, etc.), haematological (anaemia, etc.), musculoskeletal, etc.  

 

 

Shortness of breath / Dyspnoea :

• Acute, sudden, intense => call 15 / emergency consultation

• In non-emergency cases => cardiological assessment after referral by the attending physician to rule out any extra-cardiac cause

 

Possible causes of dyspnoea :

• Cardiac origin: heart failure, pulmonary embolism, pericardial effusion, heart rhythm disorder, valvulopathy

• Extra-cardiac origin: infectious and non-infectious pneumopathies, laryngeal or tracheal obstruction, pneumothorax, pleural effusion, asthma, chronic bronchitis, other pneumological diseases, anaemia, etc.

 

 

Heart palpitations :

• Extrasystole: sensation of jerking or jolting, of beating more or less with a pause

• Sustained tachycardia or arrhythmia: sensation of the heart beating faster (> 100 bpm) and/or irregularly

 

In the event of spontaneous, intense and prolonged symptoms and/or symptoms associated with other cardiac symptoms => call 15 / consult the emergency department

In other cases: overall and cardiological assessment on an outpatient basis

Possible causes of rhythm disorders :

• Cardiac origin: underlying heart disease, acute infarction, rhythmic disease

• Extra-cardiac origin: metabolic deficiencies, anaemia, hyperthyroidism, consumption of stimulants/toxic substances, secondary effects of medication, anxiety disorder, etc.

 

 

Faintness / Syncope : 

• Syncope = sudden loss of consciousness with no warning signs 

• Lipothymia = sensation of loss of consciousness with warning signs such as sweating, heat, dizziness, blurred vision, ringing in the ears, but without total loss of consciousness.

 

Note: lipothymia can be followed by syncope, or be isolated, just as syncope can be preceded by lipothymia or be isolated.

 

Possible causes:

• Cardiac origin: cardiac conduction disorder, cardiac rhythm disorder, cardiac obstruction (valvular stenosis, obstructive heart disease, pulmonary embolism, severe pericardial effusion / tamponade, pulmonary arterial hypertension, etc.).

• Extracardiac origin: most frequent cause = vagal +/- related to orthostatic hypotension.