History

Context: is there known cardiac disease (Table 49.1)?

Associated chest pain? (If so, consider acute coronary syndrome, pulmonary embolism or acute aortic syndrome)

Associated breathlessness?

Comorbidities?

Examination

Mental status

Skin perfusion, sweating

Heart rate and blood pressure

Jugular venous pressure (elevated in pulmonary embolism with shock, cardiac tamponade and right ventricular infarction)

Arterial pulses

Murmurs (often absent even with critical valve disease, if there is low cardiac output)

Respiratory rate

Arterial oxygen saturation

Signs of pulmonary oedema