Cardiac Evaluation Flashcards
____ occurs in lung and heart conditions that reduce the amount of oxygen in the blood.
Clubbing
What is the severity scale for pitting edema?
0 - No pitting edema
1 - Mild (2mm depression that disappears rapidly)
2 - Moderate (4mm depression that disappears in 10-15 sec)
3 - Moderately severe (6mm depression that lasts more than 1 minute)
4 - Severe (8mm depression that lasts more than 2 minutes)
____ is used to detect normal and abnormal heart sounds.
Phonocardiography
What is a crescendo?
A sound that is soft to loud
What is a decrescendo?
A sound that is loud to soft
What does “pansystolic” mean?
Two chambers are widely different in pressure (MR or TR)
During ____ there is an increase in TR TS, PI, PS, & venous return.
Inspiration
During ____ there is an increase in MR, MS, AS, AI (inversely relates to right side).
Expiration
The first heart sound, S1 is produced by the closure of the ____ and ____ valve.
Mitral; Tricuspid
The mitral valve closes slightly ____ the tricuspid valve.
Before (because pressures in the left side are higher than the pressures in the right side)
S1 marks the beginning of ____ ____.
Isovolumic contraction
S1 will become louder if you increase ____ (MR and TR).
Output
The second heart sound, S2 is produced by closure of the ____ and ____ valves.
Pulmonic; Aortic
S2 marks the beginning of ____ ____.
Isovolumic relaxation.
____ is higher pitched and shorter than ____ and tends to sound louder.
S2; S1
S2 may intensify with ____ ____.
Systemic hypertension
S2 may decrease in intensity with ____.
Hypotension
Heart sounds: what is associated with a Loud S1?
Rheumatic MS
Heart sounds: what is associated with an opening snap?
Rheumatic MS or TS
Heart sounds: what is associated with an ejection sound or click?
Congenital PS or AS
Heart sounds: what is associated with MVP?
Midsystolic click
Heart sounds: what is associated with a fixed split S2?
ASD
Heart sounds: what is associated with a pericardial effusion?
pericardial friction rub
Heart sounds: what is associated with a pericardial knock?
Pericarditis
Where can you best hear an aortic murmur?
Right upper sternal border
Where can you best hear a pulmonic murmur?
Left upper sternal border
Where can you best hear a tricuspid murmur?
Left lower sternal border
Where can you best hear a mitral murmur?
Apex
What are some causes of a systolic murmur?
- Obstruction to the outflow tract (semilunar valves)
- Incompetent AV valves
- Structural deformities of the aorta or pulmonary artery
- Ventricular septal defect (VSD) - holosystolic
What are some causes of a diastolic murmur?
- Incompetent semilunar or stenotic AV valves.
- Early diastolic murmurs usually result from insufficiency of a semilunar valve or dilation of the valvular ring.
- Mid and late diastolic murmurs are generally caused by narrowed, stenotic mitral or tricuspid valves that obstruct blood flow.
What sound is caused by the vibration of the ventricular walls during rapid passive filling in early diastole?
S3
S3 may also be referred to as ____ ____.
Ventricular gallop
An S3 sound may be normal finding in those under age ____.
30 (this is because younger people tend to have more compliant hearts)
What heart sound is always abnormal?
S4
S3 is the ____ wave.
E
S4 is the ____ wave.
A
What sound is caused by vibration of the valves, supporting structure, and ventricular walls during the second phase of rapid ventricular filling in late diastole?
S4
What are some conditions that cause an S3 sound?
-High cardiac output
- Large left to right shunts
- Anemia
- Valve regurg
- Cardiomyopathy
S4 may also be referred to as ____ ____.
Atrial gallop
What are some conditions that cause an S4 sound?
- HTN
- Significant semilunar valve stenosis
- CAD
- Acute MR
Are S3 and S4 low or high pitch?
Low pitch
