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57 Content of the training material The first stage of the nursing process (nursing examination of the patient) Main complaints of the patient • Heart pain  is one of the most common symptoms in everyday medical prac- tice. A doctor’s correct assessment of the subjective feelings of a patient with chest pain is one of the key stages in making a diagnosis that determines the patient’s future. Depending on the cause of heart pain, it can be grouped as follows: 1. Pain caused by heart disease (so-called heart pain): 1.1. coronary Pain (angina, angina) – caused by pathology of the coronary arteries. 1.2. non-Coronary pain (cardiology) – myocardial and pericardial damage. 2. Pain caused by pathology of large vessels (aorta, pulmonary artery). 3. Pain caused by pathology of the bronchopulmonary apparatus and pleura. 4. Pain associated with pathology of the spine, anterior chest wall and shoulder girdle muscles. 5. Pain caused by pathology of the mediastinal organs; 6. Pain associated with diseases of the abdominal cavity and pathology of the diaphragm. • Heartbeat (cardiopalmus) – subjective sensation of heart tremors in the heart area or outside of this area. The heartbeat occurs both in the presence and in the ab- sence of heart damage and largely depends on the sensitivity of the nervous system of the person. Palpitations, most often accompanied by accelerated heart activity, can also be felt during normal or even slow heart activity. Tachycardia and heartbeat are two different concepts, and a simple increase in heart rate, if it does not cause subjective sensations in the patient, is incorrectly called a heartbeat. • Shortness of breath -a violation of the rhythm, frequency and depth of breath- ing, accompanied by a feeling of lack of air. Shortness of breath in diseases of the cardiovascular system is a consequence of insufficient work of the left heart: mitral valve defects, dystrophic changes in the heart muscle, myocardial infarction. There are inspiratory shortness of breath (difficult to inhale), expiratory (dif- ficult to exhale) and mixed (difficult to inhale and exhale). For heart diseases, in- spiratory dyspnea is characteristic, due to left ventricular failure, stagnation in the small circle of blood circulation; expiratory dyspnea, characteristic of lung dis- eases, occurs when the lumen of small bronchi and bronchioles is narrowed. The cause of coughing  in heart patients is stagnation of blood in the small circle of blood circulation. The cough is usually irritating, persistent, and dry. Bothers the patient during the day with physical exertion, less often at rest, when the patient goes to bed.