09 - 50 yo F with palpitations

Question 1

what are the 5 Ps of pain characteristics that decrease the likelihood of ACS?

Answer 1

• pleuritic
• pulsating
• positional (eg pericarditis)
• palpation (reproduced by)
• pain (stabbing)

Question 2

midsystolic click with holosystolic murmur?

Answer 2

MVP

Question 3

systolic murmur left sternal border increasing with valsalva?

Answer 3

hypertrophic obstructive cardiomyopathy (may be associated with Afib)

Question 4

harsh crescendo-decrescendo murmur radiating into carotids

Answer 4

aortic stenosis

Question 5

what are loop recorders? what is their role in palpitations / dysrhythmias?

Answer 5

• monitor heart activity for weeks to months, while the patient goes about regular daily ativities
• increased diagnostic yield with regard to detecting dysrhythmias in patients with palpitations