Cardiac Assessment Flashcards
Normal troponin value
less than .1
MI troponin level
.4
Troponin level to check with MD
.1-.4
Apical Pulse
palpate at 5th interspace, midclavicular vertical line
Femoral Pulse:
Palpate over femoral artery in inguinal area
Popliteal
palpate over popliteal artery, behind the knee with the knee flexed slightly
Pedal
palpate over dorsalis pedis artery, dorsal medial aspect of foot; used to monitor lower extremity circulation
Tachycardia
> 100bpm
Bradycardia
< 60bpm
Postural Tachycardia Syndrome
Sustained heart rate increase > or equal 30 bpm within 10 mins of standing (> or equal 40bpm in teens)
Irregular Pulse
Variations in force and frequency; my be due to arrhythmias, myocarditis
Weak, Thready Pulse
May be due to low stroke volume, cardiogenic shock
Bounding, Full Pulse
May be due to shortened ventricular systole and decreased peripheral pressure; aortic insuffiency
Normal MAP
70-110 mmHg
Aortic area
Near 2nd intercostal space just right of sternum
Pulmonic area
2nd intercostal space just to the left of the sternum
Tricuspid area
Lower left sternal border 4th intercostal space
Bicuspid/Mitral area
5th intercostal space medial to the midclavicular line
S1: “LUB”
Normal closure of mitral and tricuspid valves
Marks beginning of systole
Decreased in 1st degree heart block
S2: “DUB”
Normal closure of aortic and pulmonary valves
Marks end of systole
Decreased in aortic stenosis
Gallop Rhythm
An abnormal heart rhythm with 3 sounds in each cycle; resembles the gallop of a horse
1st Heart Sound
S1 (the lub of the lub-dub)
Associated with the closure of the mitral and tricuspid valve
Corresponds with onset of ventricular systole
The 2nd Heart Sound
S2 (the dub of the lub-dub)
Associated with the closure of the aortic and pulmonary valves
Corresponds with the end of systole
Has greatest intensity when auscultated at aortic or pulmonary regions
3rd Heart Sound
Occurs early in diastole while the ventricle is rapidly filling
Immediately following S2 and sounding like lub-dub-dub
Low pitched and must be auscultated with bell
Best performed with patient laying on left side so apex is closest to chest wall
S3: Ventricular Gallop
Kentucky” – “Lub-Dub-Dee” “Slosh-in-in”
May be audible after S2
Low pitched sound near apex (Bell)
Normal in healthy children, young adults, & athletes
Represents diastolic dysfunction or reduced ventricular compliance
S4 “Tennessee”
Heard in patients with:
Hypertensive heart disease
CAD
Cardiomyopathy
Jugular Vein Distention
Positive if vein distends above level of the clavicle
Sign of: Right sided heart failure
Right Sided Heart Failure:
Swollen legs/feet Upset stomach Loss of appetite Nausea/vomiting Low BP Sudden weight gain of 10+ pounds
Left Sided Heart Failure:
SOB
Cough
Pink Frothy tinged sputum
Difficulty breathing lying down
