Brief Notecards

Question 1

Aortic Stenosis

Answer 1

S:

• exertional angina
• exertional syncope
• HF

O:

• loud, harsh mid-systolic crescendo-decrescendo murmur RUSB radiating to carotids
  
  • decreases with valsalva and standing (drops preload so less V going through small space)
• may have opening/ejection click right after S1
• enlarged, diffuse PMI
• pulsus parvus et tardus (delayed carotid upstroke)
• HoTN
• narrow pulse pressure

TX:

• slow and low dosing
• B blockers my exacerbate with ionotropic effects
• vaso dilators reduce afterload can lead to decreased outflow
• nitrates/diuretics may exacerbate with diminished preload

Question 2

Aortic Regurg

Answer 2

S:

• soft, high pitched early diastolic decrescendo at erb’s point
  
  • accentuated at end expiration and pt sitting up and leaning forward
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