Cardio/BV Textbook Questions Flashcards
Still murmur quality?
Grade 1/2
Midsystolic, without radiation, medium pitch, blowing, refit and s2 splitting common
Located in 2nd L ICS
Heard in recumbent may disappear when patient sits or stands
Structural heart disease is more likely when the murmur is….
Holosystolic Diastolic Grade 3+ With systolic click Increase with standing Harsh quality
For systolic murmurs, inspiration increases or decreases intensity
Increases
Exhalation decreases intensity
Distinguish hypertrophic murmurs
Valsalva increases intensity
Distinguish cardiomyopathy systolic murmurs
Squatting to standing increases
Leg elevation of 45 degrees decreases
Distinguish mitral regurgitation
Handgrip increases intensity of murmur
Ventricular septal defect murmur distinguishing factor
BP cuff 20-40 and it increases intensity in 20 seconds
Causes of thrills
Aortic, pulmonic, mitral stenosis Ventricular septal defect Aortic/Mitral regurgitation Tetralogy of fallot PDA Aneurysm of ascending aorta
Where would you feel a thrill if ventricular septal defect present?
4th left ICS
Where would you feel a thrill in tetrology of fallot
Left lower sternal boarder
Where would you feel a thrill in mitral regurgitation
Apex of heart
Where would you feel a thrill in PDA
Left upper sternal boarder
Where would you feel a thrill in aneurysm of ascending aorta
Right sternal boarder
Where would you feel a thrill in mitral stenosis
Apex
What is a pulse characterized by alternation of a pulsation of small amplitude and then large but with a regular rhythm
Pulsus alternans
What is a pulse characterized by two main pees. The first termed the percussion and the second termed the tidal wave. The first is thought to be pulse pressure and the second the reverberation from the periphery
Pulsus bisferiens
What is the pulse that is a result from a normal pulsation followed by a premature contraction. The amplitude of the pulsation of the premature contraction is less than the normal
Bigeminal pulse
What is the pulse that is hyperkinetic and readily palpable and it does not :fade out” and is not easily obliterated by the examiners fingers. 3+
Large, bounding pulse
What is the pi;se that is characterized by an exaggerated decrease in the amplitude (>10mmHg) of the pulsation during inspiration and increased during exhalation
Paradoxic pulse
What is the pulse that has a greater amplitude than expected, a rapid rise to a narrow summit and then a sudden descent
Water-hammer pulse
Aka Corrigan pulse
When might you hear a venous hum
Anemia
Pregnancy
Thyrotoxicosis
Intracranial AV malformation
How does breathing affect the jugular peak
Pulse wave decreases on inspiration and increases on expiration
What is suspected if edema occurs without pitting?
Arterial insufficieny
Lymphedema
What may cause pulsus alternans
LV failure
What may cause pulsus bisferiens
Aortic stenosis and insufficiency
What may causes bigeminal pulse
Disorder of rhythm
What may cause large, bounding pulse
Exercise Anxiety Fever Hyperthyroidism Aortic rigidity Atherosclerosis
What may cause paradoxic pulse
Premature cardiac contraction Tracheobronchial obstruction Bronchial asthma Emphysema Pericardial effusion Constrictive pericarditis
What may cause water-hammer pulse (corrigan pulse)
PDA
Aortic regurgitation
What may cause mitral regurgitation
Rheumatic fever
Myxoma
MI
What may cause mitral valve prolapse
Associated with pectus excavatum
What causes aortic regurgitation
AS
Endocarditis
Rheumatic heart disease
When do you hear aortic regurgitation
Early diastole
What may cause pulmonic regurgitation
Pulmonary HTN
B. Endocarditis
What may cause tricuspid regurgitation
Congenital
B. Endocarditis
Pulmonary HTN
What may cause mitral stenosis
Rheumatic fever
Cardiac infection
What may cause aortic stenosis
Rheumatic heart disease
Congenital bicuspid
Atherosclerosis
What may cause subaortic stenosis
Fibrous ring
What may cause pulmonic stenosis
congenital
What may cause tricuspid stenosis
Associated with mitral stenosis
Rheumatic heart disease
Congential
RA myxoma
