Page 8 - SSB MED EBOOK

CARDIOVASCULAR SYSTEM

Relevant history. History of chest pain, breathlessness, palpitation,

fainting attacks, giddiness, rheumatic fever, chorea, frequent sore

throats and tonsillitis should be given due consideration in

assessment of the cardiovascular system.

Pulse. The normal pulse rate varies from 60-100 bpm. Persistent

sinus tachycardia (> 100 bpm), after emotional factors and fever

are excluded as causes, as well as, persistent sinus bradycardia (<

60 bpm), should be referred for specialist opinion to exclude

organic causes. Sinus arrhythmia and vagotonia should be also be

excluded.

Candidates are quite prone to develop White Coat Hypertension,

which is a transient rise of Blood Pressure, due to the stress of

medical examination. Every effort must be made to eliminate the

White Coat effect by repeated recordings under basal conditions.

When indicated, ambulatory BP recording must be carried out or

the candidate admitted to hospital for observation before final

fitness is certified. An individual with BP consistently greater than

140/90 mm Hg shall be rejected.

Evidence of organic cardio vascular disease will be cause for

rejection. Diastolic murmurs are invariably organic. Short systolic

murmurs of ejection systolic nature and not associated with thrill

and which diminish on standing, specially if associated with a

normal ECG and Chest X-Ray, are most often functional. However