Cardiac Cycle and Sounds (Stewart) Flashcards
What are the two heart sounds?
Lub (S1)
Dub (S2)
Helpful menumonic to remember to assessment points for a CV exam?
All | Aortic Area (1)
Physicians | Pulmonic Area (2)
Take | Tricuspid Area (4)
Money | Mitral area/apex (5)
What is the order of heart sounds?
S4 –> S1 –> S2 –> S3
Describe what is occuring during:
S1
“lub”
Closure of A-V valves
Describe what is occuring during:
S2
“dub”
Closure of semilunar valves
Describe what is occuring during:
S3
“Ken-Tuckee”
A vibratory sound that occurs from blood filling the relaxed venticle. A normal sound in children but can indicate heart pathology in adult.
Describe what is occuring during:
S4
“Tenness-ee”
Atrial filling from high pressure from SVC/IVC and pulmonary venous return. Occurs BEFORE S1 heart sound.
Pathologic heart sound
Define:
Regurgitation
Turbulent flow sound when blood is moving in an opposite direction from what is should
Define:
Stenosis
Turbulent flow when blood is moving through a stiff damaged valve
How are heart murmurs graded?
What are the mneumonics to remember what makes murmurs loud or soft?
RINspiration : Inspiration, Right = louder
LEXpiration : Expiration, Left = louder
What should you know about aortic stenosis?
Crescendo-Decrescendo murmur “whooshing” sound
Old-SAD (syncope, angina, dyspnea)
Radiates up into the carotids
What is occuring during
Ventricular Systole?
OPEN semi lunar valves, Aortic and Pulmonic
CLOSED AV valves, Tricuspid and Mitral
What is occuring during
Atrial Systole?
OPEN AV valves, Tricuspid and Mitral
CLOSED semilunar valves, Pulmonic and Aortic
Exceptions to the general rules of preload?
HOCM (Hypertropic obstructive cardiomyopathy): heart is becoming really muscular –> increase preload, improves murmur, decrease preload –> worsens aortic murmur
MVP (mitral valve prolapse): leaflets of mitral valve prolapse. Increase in preload improves murmur
Effect on murmurs?
Increased afterload =
Decreased afterload =
Increased afterload = LOUDER
Decreased afterload = SOFTER
*Exceptions: HOCM, MVP
Mitral Regurgitation?
What do you need to know?
What is the mneumonic associated with tricuspid regurgitation?
Want to TRI some drugs??
History of IV drug use, related to tricuspid regurgitation
What is the mneumonic associated with aortic regurgitation?
AR, thar she blows!!!
Early blowing diastolic murmur
*HEAD BOBBING heavily associated
What are the mneumonics for mitral stenosis?
The Operating System is MicroSoft
The OS is MS
Opening snap is Mitral stenosis
*RHEUmitral = rheumatic fever associated
HOCM (hypertropic obstructive cardio myopathy)
Associated with?
Death at young age
*EXCEPTION TO THE RULE of loudness with preload/afterload
What is the mneumonic for mitral valve prolapse?
See the MVP to be the MVP and everything will click
Midsystolic “click”
*closely associated with young women with psych hx
