Cardiac Complaint Flashcards

1
Q

Where is PMI?

A

4th or 5th intercostal space at midclavicular line

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2
Q

What is the significance of JVP?

A

Level of JVP visibility gives indication of RAP

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3
Q

How do you look at JVP?

A
  • Place patient supine allow veins to engorge
  • Raise patient 30-45 degrees
  • Most peoples hearts are 5 cm below the horizontal plane of the sternal notch
    • Measure height of most distended part of vein to the sternal notch
  • 0-9 is normal
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4
Q

S2?

A

Reflects diastole, closure of ASL and PSL valves

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5
Q

What is A wave?

A
  • Right atrial contraction
  • triscupid open coincides with S1
  • Preceeds carotid pulsation
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6
Q

What can cause a giant A wave?

A
  • obstruction between RA and RV
  • Increasaed RV pressure
  • Pulm Htn
  • Recurrewnt pulmonary emboli
  • AV dissociation
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7
Q

What is C wave?

A
  • Backwards push by closure of the Tricuspid valve during isovolumetric systole and impact of carotid artery adj to JV
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8
Q

What is X wave

A
  • Passive atrial filling and relaxation, blood flows into RA from vena cava and closure of tricuspid occurs
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9
Q

What could cause a steep X wave?

A
  • Cardiac tamponade
  • Constrictive pericarditis
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10
Q

What is V wave?

A
  • Atrial filling
  • Increasing volme and pressure in RA when tricupsid is closed
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11
Q

What causes prominent V wave?

A
  • Triscupid regurgiation
  • Pulmonary Htn
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12
Q

What is Y slope?

A
  • Triscupid opens and rapid RV filling occurs
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13
Q

What causes steep Y descent?

A
  • Severe triscupid regurgitation
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14
Q

What does a slow Y descent mean?

A

Obstruction for RV filling

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15
Q

what causes increased JVP?

A
  • Sup vena cava obstruction
  • Severe heart failure
  • Constrictive pericarditis
  • Cardiac tamponade
  • RV infarction
  • Restrictive cardiomyopathy
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16
Q

Positive HJR seen with?

A
  • Poorly compliant RV, RV failure
  • Constrictive pericarditis
  • Obstructive RV filling
17
Q

What is S3?

A
  • Due to high pressures and abrupt deceleration of inflow across the mitral valve at the end of the rapid filling phase
  • Ken- Tuck- Y
18
Q

S4?

A
  • Atrial gallop from forcefulcontraction of atria against stiffened ventricle
  • Ten-Nes-See
19
Q

When does physiologic splitting of S2 occur?

A

Inspiration

20
Q

Where do you listen for the Mitral valve?

A
  • 5th left ICS at midclavicular line
21
Q

Where do you listen for Triscupid?

A
  • 4th left ICS at LSB
22
Q

Where do you listen for aortic valve ?

A

2nd ICS to the R of sternum

23
Q

Where do you listen for pulmonic valve?

A
  • 2nd ICS L of sternum
24
Q

Murmur grading system?

A
  1. Barely audible
  2. Soft, but easily heard
  3. Loud, without a thrill
  4. Loud with a thrill
  5. Loud with minimal contact between stethoscope and chest –Thrill
  6. Loud, can be heard without a stethoscope -Thrill