Bates' Tables Cardiac (through 9-5) Flashcards
What are the 4 types of fast regular patterns on the EKG?
Sinus tachycardia
Supraventricular tachycardia
Atrial flutter with a regular ventricular response
Ventricular tachycardia
What are the 3 types of patterns with a regular and normal rate and rhythm on EKG?
Normal sinus rhythm
Second-degree AV block
Atrial flutter with a regular ventricular response
What are the 3 types of patterns with a regular and slow rate and rhythm on EKG?
Sinus bradycardia
Second-degree AV block
Complete heart block
What is the rate (i.e. #) of a fast beat?
> 100
What is the rate (i.e. #) of a normal beat?
60-100
What is the rate (i.e. #) of a slow beat?
<60
What are the three types of irregular rhythm?
Irregularly irregular
regularly irregular
sporadic
What is the rhythm with premature or extra beats at random intervals, but normal underlying rhythm?
sporadic
What are regularly irregular rhythms?
regular pattern of cadences
What are irregularly irregular rhythms?
no discernible regularity
Identify the ECG pattern based on rate: 110-250
Ventricular tachycardia
Identify the ECG pattern based on rate: 100-175
Atrial flutter with a regular ventricular response
Identify the ECG pattern based on rate: 100-180
Sinus tachycardia
Identify the ECG pattern based on rate: 150-250
Supraventricular tachycardia
Identify the ECG pattern based on rate: 30-60
Second degree AV block
What has a EKG rate below 40?
Complete heart block
In the healthy heart, the left ventricular impulse is usually…
the point of maximal impulse (PMI)
What are the classic descriptors of left ventricular PMI? (Location, diameter, amplitude, duration)
Location= midclavicular, intercostal space 4 & 5
Diameter= discrete; ≤ 2cm
Amplitude: brisk and tapping
Duration: ≤2/3 (two thirds) of systole
When can right ventricular impulse be felt?
at infancy, but not palpable beyond that
When is S1 accentuated?
tachycardia, rhythms with a short PR interval, high cardiac output states and mitral stenosis
When is S1 diminished?
first-degree heart block, mitral valve calcification, mitral regurgitation, left ventricular contractility reduced (i.e. HF, CHD)
When does SI vary in intensity?
complete heart block (atria/ventricles beating independently), irregular rhythm
When does SI split in abnormal conditions?
right bundle branch block and premature ventricular contractions
Where can you hear physiologic splitting of S2?
2nd or 3rd left interspace
Is normal S2 splitting heard at inspiration or expiration?
Inspiration (absent during expiration)
Is wide S2 splitting heard at inspiration or expiration?
Heard during both, but the split is wider during inspiration
What are common causes of wide splitting of S2?
delayed closure of pulmonic valve (as in pulmonic stenosis or right bundle branch block) or early closure of aortic valve (as in mitral regurgitation)
What is a common cause of split S1 and wide splitting of S2?
right bundle branch block
What is wide splitting that does not vary with respiration called?
fixed splitting (occurs with ASD and right ventricular failure)
What variation in S2 has the pulmonic valve closing before the aortic valve closes during expiration?
paradoxical or reversed splitting
In paradoxical or reversed splitting, what happens with S2 sound on inspiration?
No splitting of A2 or P2 –> S2 is one sound only because delay of P2 makes the normal split disappear
What S2 sound is normally caused by left bundle branch block?
paradoxical or reversed splitting
Where can you hear increased intensity of A2?
right 2nd intercostal
What sound would calcific aortic stenosis cause?
decreased or absent A2 in the right 2nd intercostal
When you hear this sound you should suspect pulmonary HTN, dilated pulmonary artery, or ASD
when P2 is equal to or louder than A2
When does decreased or absent P2 occur?
increased anteroposterior diameter of the chest associated with aging or pulmonic stenosis
What is early systolic ejection sounds associated with?
cardiovascular disease
When do early systolic ejection sounds occur?
coincide with opening of aortic and pulmonic valves
What does a mitral valve prolapse usually cause?
systolic clicks
When do systolic clicks occur?
mid or late systolic
Is it abnormal or normal to detect S3 in children and people under 40 and 3rd trimester of pregnancy?
normal
Decreased myocardial contractility, heart failure, volume overloading of the ventricle cause this sound
S3
When is S4 normal?
older people and trained athletes
HTN heart disease, myocardial ischemia, aortic stenosis, and cardiomyopathy produce this heart sound
S4
What is it called when S3 and S4 merge into one loud extra heart sound?
summation gallop
Continuous sound without a silent interval
Loudest in diastole
Hear above medial 1/3 of clavicle (esp R)
Humming, roaring
Low pitch
Venous Hum
May have 3 components
Heard best in 3rd interspace to L of sternum
High pitch
Scratchy, scraping sound
Pericardial friction rub
Continuous murmur heard in both systole and diastole, silent interval in late diastole Obscure S2 Radiates towards left clavicle harsh, machinery-like medium pitch
Patent Ductus Arteriosus
