Cardiac Exam Flashcards
What is the PAR-Q used for
screening for CVD - if any questions are answered “yes” then the pt needs medical clearance
what are the 8 CVD risk factors defined by the ACSM
age, fam hx, smoking, HTN, dyslipidemia, pre-DM, obesity, sedentary lifestyle
how can you stratify a patient’s risk for getting CVD per the ACSM 8 risk factors?
low risk: asymptomatic and < 2 RFs
mod risk: asymptomatic and 2 or more RFs
high risk: symptomatic or known disease
if a patient is at moderate risk for CVD do they need medical clearance to exercise?
not usually for low-mod intensity activity but medical clearance should be considered for high intensity training
what is normal pulse pressure and what does it mean if its narrowing?
normal 40-60; narrowing means acute heart failure
describe JVD positioning and interpret a positive sign
supine with HOB elevated to 45 deg; positive venous distention is an early sign of R CHF
how do you know that a patient’s chest pain is MSK in origin?
pain present during palpation, deep breathing, and activity
how do you know that a patient’s chest pain is pulmonary in origin?
pain present during deep breathing, and activity
how do you know that a patient’s chest pain is cardiac in origin?
pain presents during activity only
the diaphragm picks up ____ pitch sound, and the bell picks up _______ pitch sound
high; low
mnemonic for remembering where to auscultate heart sounds
APT-M 2245
aortic, pulmonary, tricuspid, mitral
what is the lub sound? where is it loudest on auscultation? what phase of the heart does it signal?
S1
- closure of the mitral and tricuspid valves
- loudest at the apex or tricuspid
- begins ventricular systole
what is the dub sound? where is it loudest on auscultation? what phase of the heart does it signal?
S2
- closure of the aortic and pulmonic valves
- loudest at A and P regions
- begins ventricular diastole
What is the S3 sound? where can you hear it? what does it mean?
S3
- ventricular gallop
- loudest at mitral area
- early sign of ventricular failure (but common and benign in late pregnancy)
what is the S4 sound? where can you hear it? what does it mean?
S4
- atrial gallop
- loudest in mitral area
- assoc with resistance to ventricular filling, LV hypertrophy, and MI
with what pathologies do you tend to hear murmurs?
valvular stenosis and regurgitation
what is the advantage of max exercise testing
better estimate of VO2 max and increased sensitivity to dx coronary artery disease in asymptomatic individuals
What is VO2max
measurement of cardiorespiratory fitness that is closely related to functional capacity of the heart
how long does a max exercise stress take?
8-12 minutes total of steadily progressive 2-3 minute stages
A VO2 max below the ____ percentile, often indicative of a sedentary lifestyle, is associated with increased risk of death from all causes
20th
why is submax exercise testing used
it is used to evaluate early recovery of patients after an MI or cardiac event
For 40-80 year old men, what is the 5th percentile, median, and 95th percentile for the 6MWT
399, 576, 778 meters
think (400, 600, 800)
for 40-60 year old women, what is the 5th percentile, median, and 95th percentile for the 6MWT
310, 494, 664 meters
think (300, 500, 650)
write a goal for the 6MWT
Pt will improve 6MWT distance from x to y to minimize risk of future cardiac event/dysfunction
