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Echo 3 murmurs/stress test/ecg/doppelr/hemo > cardiac murmurs and auscultation & Tumors > Flashcards

cardiac murmurs and auscultation & Tumors Flashcards

1
Q

s1

A
  • closure of the MV and TV, main sounds
    occurs at the beginning of systole during ventricular contraction
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2
Q

s2

A

closure of AV and PV
occurs at the beginning of diastole during ventricular relaxation
creates the DUB sound

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3
Q

s3

A

ventricular gallop
may signal cardiac issues like CHF

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4
Q

s4

A

atrial gallop

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5
Q

types of mid systolic murmurs

A

AS
PS
HOCM
ASD

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6
Q

aortic stenosis

A

harsh and high pitched loud to soft noise
decreased EF can underestimate the degree of stenosis

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7
Q

location of auscultation for AS

A

right upper sternal border
carotids

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8
Q

when does mild AS peak

A

early systole

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9
Q

when does severe AS peak

A

later in systole

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10
Q

pulmonic stenosis

A

high pitched loud to soft noise
similar to AS

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11
Q

location of auscultation for PS

A

pulmonic listening post
radiates towards neck

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12
Q

HOCM

A

high pitched loud to soft noise
does not radiate to carotids

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13
Q

holosystolic murmurs

A

MR TR VSD

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14
Q

MR auscultation

A

apex
high pitched blowing sound

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15
Q

TR auscultation

A

left sternal border
high pitched blowing sound

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16
Q

VSD flows from

A

higher pressure LV to lower pressure RV
the smaller the louder the murmur

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17
Q

late systolic murmur mitral valve prolapse

A

listen for at apex
high pitched
mid systolic click

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18
Q

early diastolic murmurs

A

AI
PI

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19
Q

AI

A

listen for at 3rd intercostal space
soft and high pitched

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20
Q

Austin flint murmur

A

severe AI low pitched
mid to late diastole

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21
Q

PI

A

listen for at 3rd or 4th intercostal space
soft and lowpitched
graham steele murmur

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22
Q

mid to late diastolic murmurs

A

MS and TS

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23
Q

what does MS sound like

A

opening snap from high left atrial pressures
low pitched diastole rumble
listen for at apex

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24
Q

listen for TS

A

lower left sternal border
similar to MS

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25
Q

PDA : patent ductus arteriosus

A

continuous murmur
begins at S1 and peaks at S2

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26
Q

pulsus alternans

A

a strong pulses followed by a weaker pulse
progressive systolic heart failure
a flag that the heart is trying to sustain itself in systole

27
Q

pulsus bigeminus

A

hoofbeats within each heartbeat
heartbeats occurs closely to each other followed by a long pause

28
Q

pulsus bisferiens

A

seen with aortic valve disease
2 pulses to each heartbeat

29
Q

pulsus tardus

A

stiff aortic valve
av harder to open causing increase in lv pressure

30
Q

pulsus paradoxus

A

where some heartbeats cannot be detected at the radial artery during inspiration
caused by an exaggerated decrease In BP

31
Q

JVP is used to assess what

A

central venous pressure
high JVP = high CVP

32
Q

multiphasic JVP

A

JVP beats twice in the cardiac cycle

33
Q

paradoxical JVP

A

jvp rises with inspiration drops with expiration called kussmauls sign
seen with pericardial eff. tamponade and pericarditis

34
Q

JVP can help differentiate between …

A

heart and lung disease

35
Q

myxoma

A

intracardiac tumors
most common benign tumors in adults, in females
made up of mucous cells
USUALLY in LA

36
Q

sono of myxoma

A

heterogenous with sharp demarcated borders
mottled appearance
mimics valvular stenosis

37
Q

symptoms of myxoma

A

diastolic murmur
syncope
chest pain
may have stroke due to embolize

38
Q

lipoma

A

benign
dumbbell shape over fossa ovals
mature fat cells
location: LV RA IAS

39
Q

fibroma

A

2nd most common pediatric tumor
location usually LV or RV

40
Q

fibroma sono

A

intramural and solitary
usually large

41
Q

S & S of fibroma

A

left axis deviation
CHF
LVOT obstruction
ventricular arrhythmias

42
Q

rhabdomyoma

A

most common tumor in children
associated with Pringles disease

43
Q

rhabdomyoma usual location

A

usually in LV or RV

44
Q

s & s of rhabdomyoma

A

majority asymptomatic
av block
pericardial effusion
arrhythmias

45
Q

teratoma

A

rare in children
usually in RA

46
Q

papillary fibroelastoma

A

second most common tumor
most common valvular tumor

47
Q

usual location of papillary fibroelastoma

A

on MV or AV in adults
TV in children

48
Q

soon appearance of papillary fibroelastoma

A

move independently
could be on chordae

49
Q

s & s of papillary fibroelastoma

A

asymptomatic unless large and can embolize

50
Q

malignant sarcoma

A

affects men more than women
in RA
rare

51
Q

angiosarcoma

A

most common type of sarcoma
usually in RA or pericardium

52
Q

sono angiosarcoma

A

RVIT or RVOT pericardial effusion

53
Q

fibrosarcoma causes

A 
causes HF and arrhythmia 
infiltrates myocardium (anterioseptall wall)
54
Q

rhabdosarcoma

A

can be in any chamber
25% in younger patients
2nd most common malignancy

55
Q

metastatic tumors

A

40 times more common

56
Q

where do most metastatic tumors come from

A

lung, breast, renal carcinoma, or melanoma

57
Q

soon appearance of metastatic tumors

A

pericardial effusion most common finding that contains strands
profusion of mass into the chambers via IVC or pulmonary veins

58
Q

s & s of metastatic tumors

A

tamponade
heart failure
arrhythmia

59
Q

how can malignancies travel to the heart

A
  • lymphatic system
  • pulmonary veins
  • pericardium to myocardium to endocardium
    • via IVC to right heart
60
Q

apical thrombus

A
  • in areas of Akinses or dyskinesis
    • associated with anterior myocardial infarction
61
Q

types of apical thrombus

A

layered

single

multilobulated

pedunculated

62
Q

how to asses for apical thrombus

A
  • interrogated the apex with high freq. transducer
  • color flow doppler
  • alter depth
  • change views
  • contrast echo
  • TEE
63
Q

left atrial thrombus

A

can develop in patients with A fib

64
Q

normal variant: lambls excrescences

A

connective tissue with elastic bands, very thin strand on AV

Echo 3 murmurs/stress test/ecg/doppelr/hemo (5 decks)

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