Adult - Cardiology I Flashcards
Murmur
grade I/VI
barely audible
Murmur
grade II/VI
audible but faint
Murmur
grade III/VI
moderately loud
NO THRILL
Murmur
grade IV/VI
ASSOCIATED WITH A THRILL
Murmur
grade V/VI
heard with one edge of stethescope off chest wall
Murmur
grade VI/VI
heard from across the room
Which are the valves that tend to get adults “in the most amount of trouble”?
Mitral
Aortic
the LEFT heart valves
Which valve is associated with 2nd intercostal space?
aortic
Which valve is associated with 5th intercostal space?
mitral
What mnemonic works for diastolic murmur related to valvular disease?
MS ARD
mitral
stenosis
aortic
regurg
diastolic
What mnemonic works for systolic murmur related to valvular disease?
MR ASS
mitral
regurg
aortic
stenosis
systolic
What are the 4 types of heart failure?
systolic
diastolic
acute
chronic
Systolic heart failure has to do with inability to…
contract (which is what happens in systole)
In the big picture, what type of medication treats systolic heart failure?
inotrope
What do inotropes do?
Examples of inotropes
positive inotropes increase the strength of muscle contractility
(dopamine, dobutamin, digoxin)
Diastolic heart failure has to do with inability to…
relax and fill (which is what happens in diastole)
In the big picture, what type of medication treats diastolic heart failure?
dilator
Acute heart failure usually develops as a result of…
MI or valve rupture
abrupt onset
Which side of the heart is affected by acute heart failure?
L
therefore, the blood backs up into the LUNGS
What are the signs and symptoms of acute / L heart failure?
LUNG symptoms
rales
wheezing
frothy cough
S3 gallop
Chronic heart failure develops as a result of…
inadequate compensatory mechanisms
most common cause of R heart failure is L heart failure
What are the signs and symptoms of chronic / R heart failure?
SYSTEMIC symptoms
hepatosplenomegaly
JVD
dependent edema
S3 and/or S4
What is the most informative diagnostic test for heart failure and why?
echocardiogram
provides info on valve movement, wall movement, ejection fraction
management
x
NY Heart Association Heart Failure Classification -
At what stage do symptoms first appear?
stage 2
stage 1 is asymptomatic
NY Heart Association Heart Failure Classification -
What is the difference between stage 2 and stage 3?
stage 2 features SLIGHT limitations
stage 3 features MARKED limitations
both are comfortable at rest
NY Heart Association Heart Failure Classification -
what is the defining characteristic of stage 4?
symptomatic always, even at rest
What will a CXR show in heart failure? (3)
pulmonary edema
Kerley B lines
effusions
What is the difference between effusion and infiltrate?
effusion is fluid in the pleural space, which compressed the lung upward
infiltrate is within the lung itself
What is atelectasis?
collapse of all or part of the lung - develops when alveoli become deflated
What is the non-pharmacologic treatment for heart failure? (3)
sodium restriction
rest/activity balance
weight reduction
What is the pharmacologic treatment for heart failure?
ACE inhibitors (-pril)
Diuretics
if A fib also –> anticoagulation therapy
