Cardiac Exam Lecture Flashcards
What is the A wave?
R atrial contraction
TV open
Coincides with S1 and precedes pulsation
Which conditions will result in a giant A wave?
Obstruction between RA and RV (eg. TS or right atrial myxoma)
Increased pressure in RV (e.g. pulmonary stenosis)
Pulmonary HTN
Recurrent pulmonary emboli
AV dissociation (complete heart block or VT) - cannon A waves
-RA contracts against a closed TV
What is the C wave?
Backward push by closure of the TV during isovolumetric systole and by impact of carotid A adjacent to the JV
What is the X wave/slope?
Passive atrial filling and atrial relaxation
Blood flows into the RA from the cava and closure of the TV
A steep X descent is seen with which conditions?
Cardiac tamponade and constrictive pericarditis
What is the V wave?
Atrial filling
Increasing volume and pressure in RA when TV closed
A prominent V wave is seen with which conditions?
Tricuspid regurgitation and pulmonary HTN
What is the Y slope/descent?
Open TV and rapid filling in RV diastole
A deep Y descent in seen in what?
Severe tricuspid regurgitation
A slow Y descent suggests what?
Obstruction to RV filing (i.e. TS or RA myxoma)
An increased JVP is seen in which circumstances?
SVC obstruction
Severe heart failure
Constrictive pericarditis, cardiac tamponade, RV infarction
Restrictive cardiomyopathy
A positive HJR is seen in which conditions?
Poorly compliant RV (RV failure)
Constrictive pericarditis
Obstructive RV filling by TS or RA tumor
What is S3?
Due to high pressures and abrupt deceleration of inflow across the mitral valve at the end of the rapid filling phase Physiologic in children/young adults Pathology in >40 y/o Ken tuck y After S2
What is S4?
Atrial gallop from forceful contraction against stiffened (low compliant) ventricle
Can be normal in trained athletes
Ten Nes See
Occurs before S1
