9. Chest Pain DSAs

Question 1

Bruits: turbulent sounds in carotids, femoral arteries. S4 gallop is heard during angina attack and S3 gallop heard during?

Answer 1

heart failure

Question 2

non chest pain sx of ischemic heart disease include dyspnea, excessive fatigue/ weakness, dizziness, light headed/syncope, nausea/ indigestion, heartburn, epigastric pain, neck jaw pain and?

Answer 2

Diaphoresis (cold sweats)

Question 3

DDx of a STEMI includes pericarditis and myocarditis, stress induced (takotsubo) cardiomyopathy, and early ventricular repolarization in a healthy person, especially?

Answer 3

African Americans

Question 4

Unstable angina can cause elevated cardiac enzymes and ECG may reveal ST depression/ T wave inversion which results in?

Answer 4

Non STEMI (NSTEMI) myocardial necrosis

non ST segment elevation MI

Question 5

What occurs after coronary occlusion due to thrombus causing complete interruption of blood flow = transmural and on ECG will se ST elevation in 2 contiguous limb leads or 2mm ST elevation in 2 contiguous precordial leads or new LBBB?

Answer 5

STEMI

ST segment elevation myocardial infarction

Question 6

Valvular Heart disease (VHD) usually arises from myxomatous degeneration (MVP) or congeitally like bicuspid aortic valve. Murmurs usually result from turbulence across valve and or an increased?

Answer 6

blood flow

Question 7

Stenosis occurs due to pressure overload while regurgitation occurs due to volume overload. The following have what type of murmur..? MR, TR, AS, PS, VSD, ASD

Answer 7

Systolic between S1 and S2

Question 8

The following have what type of murmur? AR, PR, MS, TS, atrial myoma (aortic regurg, pulmonic regurg, mitral/tricuspid stenosis)

Answer 8

Diastolic murmur from S2 to S1

Question 9

What grade of murmur is when you start to have a palpable thrill?

Answer 9

4/6

3/6 is just a louder murmur without a thrill

Question 10

What systolic murmur is blowing at the apex, radiates into left axilla with a reduced S1?

Answer 10

Mitral Regurgitation (MVP)

Question 11

What systolic murmur is blowing, in the 4th ICS LSB increases on inspiration (carvallo sign) with prominent V wave in jugular venous pulse?

Answer 11

Tricuspid Regurgitation

Question 12

What systolic murmor has cardinal sx of dyspnea, angina and syncope, and is crescendo-decresecendo, harsh 2nd ICS, RSB, radiates into sternal notch/carotids?

Answer 12

Aortic Stenosis

Question 13

What systolic murmur is crescendo-decrescendo, 2-3 ICS LSB, and radiates to left shoulder/clavicle (maybe d/t TOF)?

Answer 13

Pulmonic Stenosis

Question 14

What is a holosystolic murmur, left lower sternal border with thrill, L to R shunt and murmur increases with hand grip?

Answer 14

Ventricular Septal defect

Question 15

What is a L to R shunt, systolic murmur, upper LSB with fixed SPLITTING of S2?

Answer 15

Atrail Septal Defect

Question 16

What causes a diastolic murmur with low pitch (use bell), rumbling at apex, increased S1 and S2 followed by OPENING SNAP?

Answer 16

Mitral Stenosis

Question 17

What causes a diastolic murmur LSB which increases on inspiration (carvallo sign) with a prominent A wave on jugular vein?

Answer 17

Tricuspid Stenosis

Question 18

What causes a diastolic decrescendo murmur in the 3rd ICS, LSB, and can mimic MS with a soft S2?

Answer 18

Aortic Insufficiency

Question 19

What causes a diastolic decresendo murmur, 2nd ICS LSB?

Answer 19

Pulmonary insufficiency