Beside Questions Flashcards
Features of long standing hypertension
• Thickened arterial wall
• Locomotor brachialis
• BP elevated or normal
• elevated JVP
• distended neck vein
• Heaving apex beat
• S4 present
• Loud A2
Heart sounds names
- S1: closure of tricuspid and mitral valve
Systole: gap between S1 and S2
Diastole: gap between S2 and S1 - S2: Closure of pulmonary and aortic valve
- S3: Occurs just after S2, rapid filling of ventricles during diastole , commonly heard in children and young adults <30, but also cardiomyopathy, aortic and mitral regurgitation and constructive pericarditis ‘Ken-tucky ’ aka ventricular gallop
- S4:Occurs just before S1 in late diastole, atrial gallop ‘Tenne-ssee’ caused by blood flow into stiff ventricles (do not relax normally) eg. in hypertrophic cardiomyopathy and systemic hypertension
Heart murmur; signs of a problem with the valves
* Systolic murmurs (more common)
* Diastolic murmur
Leading cause of unilateral leg swelling
Cellulitis
Causes of tachycardia
Physiological
* Exercise
* Anxiety
* Stress
* pain
* fever
* pregnancy
Pathological
Cardiac causes
* HF
* arrhythmias
* MI
* Pericarditis and myocarditis
Non cardiac
* hypovolemia
* hyperthyroidism
* hypoxia
* sepsis
* drug induced (caffeine, cocaine, B-agonist, amophetamines)
Causes of bradycardia
Physiological:
Athletes heart
Sleep
Pathological:
- Sick Sinus Syndrome (SSS)
- Sinus Bradycardia (Pathological)
- First-Degree AV Block
- Second-Degree AV Block (Mobitz Type I & II)
- Third-Degree (Complete) AV Block
- Myocardial Infarction (especially Inferior MI)
- Hypothyroidism
- Hypothermia
- Hyperkalemia
- Increased Intracranial Pressure (Cushing’s Reflex)
- Vasovagal Syncope
- Beta-Blocker Toxicity
- Calcium Channel Blocker Toxicity (Verapamil, Diltiazem)
- Digoxin Toxicity
- Lyme Disease (causing AV Block)
Causes of Hyperdynamic states
Hyperdynamic states occur when the body increases cardiac output (CO), heart rate (HR), and contractility due to various physiological or pathological conditions.
- High Metabolic Demand
• Sepsis (early phase)
• Fever & infections
• Hyperthyroidism
• Pregnancy - Cardiovascular Conditions
• Anemia
• Arteriovenous (AV) fistula
• Paget’s disease of bone
• Beriberi (Thiamine deficiency) - Endocrine & Systemic Causes
• Hypercapnia (high CO₂)
• Liver cirrhosis
• Obesity
Cushings triad
Virchows triad
Beck’s triad
Cushings triad (signs that indicate raise ICP):
* hypertension
* bradycardia
* irregular respirations
Virchows triad (factors that contribute to thrombosis):
- endothelial injury
- hypercoagulability
- stasis of blood flow
Beck triad (CT):
* distended neck vein
* muffled hear sound
* hypotension
Cause of polyuria
DM
Diabetes insipidus
Psychogenic polydipsia
Hypercalcemia
Hypokalemia
Early stages of CKD
AKI
Alcohol or caffeine consumption
Post obstructive diuresis
Signs and symptoms of AF
Common Symptoms
• Palpitations (irregular, fast, or pounding heartbeat)
• Fatigue or weakness
• Dizziness or lightheadedness
• Shortness of breath (dyspnea)
• Chest discomfort or pain
• Reduced exercise tolerance
Signs on Physical Examination
• Irregularly irregular pulse
• Tachycardia (rapid heart rate)
• Variable pulse volume
• Hypotension (in severe cases)
Signs on ECG (Electrocardiogram)
• Irregular R-R intervals (irregular ventricular response)
• Absent P waves
• Fibrillatory waves (f-waves)
• Narrow QRS complexes (unless there is a conduction abnormality)
Elevated T wave is seen in
Hyperthyroidism
