forms of tests. And we’ll be talking about
each of those later in this lecture.
Why is the patient’s history so very important?
Let’s consider that for a few moments.
First of all, it’s important to remember
that cardiovascular disease is the leading
cause of death in the world regardless of
racial or ethnic groups. For example, in 2012
there were 7.4 million ischemic heart disease
deaths – that is disease due to narrowing
of the blood vessels in the heart – and
6.7 million deaths that resulted from stroke.
So you can see that that’s a huge number
of people in the world who have died of cardiovascular
In making the diagnosis of either one of those
entities – ischemic heart disease or stroke
– it is critically important to know what
symptoms the patient’s been having because
that directs you in terms of your thinking
as to what’s going on in this particular
The history provides information about the
symptoms, how they might have developed. It
indicates potential or underlying disease
states. It helps in identifying significant
factors that can influence cardiovascular
health. For example, diet. And we’ll talk
a lot more about that in a moment.
90% of the diagnostic information is in the
patient’s history. So, if you don’t take
a good careful history, you’re giving away
a lot of chance to make the correct diagnosis.
In order to get a good history, it takes time.
You can’t just breeze in, listen for a few
minutes and run away. You have to listen carefully
to what the patient is saying because you
often need to interpret what they’re telling
you. The patient is not a healthcare person.
They don’t know how to organise their history.
So you’re getting it in bits and pieces
and you have to piece together the pieces
of the puzzle in order to understand what
the patient is actually telling you.