Cardiac Concepts Part 1 Flashcards
S1
“lub”, the first heart sound,
heard when the atrioventricular (mitral and tricuspid) valves close
S1 marks the end of ____________ and the beginning of _____________, and is loudest at the ________.
diastole,
systole,
apex of the heart
S2
dub,
closure of aortic and pulmonary (semilunar) valves
S2 marks the end of ________ and the beginning of _______, and is loudest at the ______.
systole,
diastole,
base of the heart (right sternal border, 2nd intercostal space)
S2 is louder with what condition?
pulmonary embolism
Wide fixed splitting of S2 is caused by what?
RBBB (right bundle branch block)
S3
an abnormal heart sound detected early in diastole as resistance is met to blood entering either ventricle; most often due to volume overload associated with heart failure
“Kentucky” right after S2
heard best at the apex with the bell of stethoscope
S3 is associated with
heart failure,
pulmonary hypertension, cor pulmonale, mitral, aortic, or tricuspid insufficiency
S4
an abnormal heart sound detected late in diastole as resistance is met to blood entering either ventricle during atrial contraction; most often caused by hypertrophy of the ventricle
“Tennessee” right before S1
heard best at the apex with the bell of stethoscope
S4 is associated with
myocardial ischemia, infarction, htn, ventricular hypertrophy, and AORTIC STENOSIS
pericardial friction rub
scraping or grating noise heard on auscultation of the heart; suggestive of pericarditis; may be positional
pulse pressure
systolic pressure - diastolic pressure
normal 40-60 mmHg
Systolic Blood Pressure (SBP) is an indirect measurement of ____
cardiac output and stroke volume
Diastolic Blood Pressure (DBP) is an indirect measurement of ____.
systemic vascular resistance (SVR)
Coronary arteries are perfused during ____.
diastole
narrowed pulse pressure, think ___.
cardiac tamponade
Widened pulse pressure think
vasodilation; often seen in sepsis, septic shock
systole
ejection, hight pressure
diastole
filling, low pressure
Why do the cardiac output and bp drop with extreme tachyarrhythmias?
no time for filling = less output
murmur of insufficiency/regurgitation
occurs when the valve is closed
(acute or chronic)
Murmur of stenosis
occur when valve is open
(chronic, NOT acute)
Systolic murmurs
aortic stenosis and mitral regurgitation; occur between s1 and s2 (lub…shhhb…dub)
Semilunar valves are OPEN during systole - aortic and pulmonic stenosis
AV valves are CLOSED during systole - mitral and tricuspid insufficiency
Ventricular septal defect (most common with acute MI) may result in a systolic murmur
Diastolic murmurs
aortic regurgitation/insufficiency and mitral stenosis; occur after s2 (lub…dub…shhb)
Semilunar valves are CLOSED during diastole- aortic and pulmonic insufficiency (AI)
AV valves are OPEN during diastole - mitral and tricuspid stenosis
Mitral stenosis is associated with AFIB d/t atrial enlargement that occurs over time
Mitral insufficiency/regurgitation occurs when the mitral valve is _____.
closed, during Systole!
Mitral stenosis occurs when the mitral valve is _____.
open, during Diastole!
Aortic insufficiency/regurgitation occurs when the aortic valve is _____.
closed, during Diastole!
Aortic stenosis occurs when the aortic valve is _____.
open, during Systole!
Nitoprusside
Drug of choice in a hypertensive emergency. A continuous infusion that reduces preload and afterload.
Assess for cyanide toxicity after a few hours - days on the drip. Signs of cyanide toxicity include change in mental status, tachycardia, seizure, and metabolic acidosis.
Ankle brachial index
Normal is > 1
To get this divide the ankle pressure by the brachial pressure on the same side of the body. This test for arterial flow and PAD
