Cardio document Flashcards
Jugular vein findings
Large V waves indicates
Pathophys
Large A waves pathophys
Indicates
Kussmaul’s sign pathophys
assc w
V- tricuspid regurg
incompetent valve allows pressure deflection during systole
A- atrial contraction on closed TCV
signifies A-V dissociation
K- rise in JVD w inspiration
Constrictive pericarditis, RV infarct, massive PE, restrictive cardiomyopathy
Carotid pulse findings dz
Bounding pulse A, P, H, E, H, A, P, W
Pulsus parvus et tardes path
Assc w
Double peaked pulse
Dicrotic (2nd pulse after S2)
Bisferious (2nd pulse before S2)
Aortic regurg, pregnancy, hyperthyroid, exercise, hyperadrenergic, anemia, Paget’s of bone, wet beriberi
slow rising carotid pulse, low amplitude
aortic stenosis
HF, pericardial tamponade, constriction
Constriction
Hypertrophic obstructive cardiomypoathy
PMI size
Location
Cardiac dilation (sys HF) PMi is
Hypertrophic HD (HTM, aortic stenosis, cardiomyopathy) PMI is
Emphysema/aging PMI is
dime
MCL in 5th intercostal space
lateral deviation, enlarged and prolonged
prolonged w palpable atrial contraction
unappreciable
Thrill suggests
Graded as
Left lower sternal pulsation (heave) suggests
Pulmonary impulse, palpate
assc w
blood movement in systolic cardiac murmurs/vascular bruits
> 4/6 intensity
RV hypertrophy (better w COPD/subxiphoid palpation)
left 2nd ICS
PA dilation (PHTN)
Pulsatile liver (rosenbach sign) assc w
and
another dz association
serve TR w regurgitant jet
AR w wide pulse pressure
pericardial constriction
Aortic insuffiency murmur timing, area
heard best w pt positioned, side of steth?
Carvallo’s sign
due to
Diastolic, LLSB
sits up, leans forward, diaphragm of steth, pt exhales/holds breath
inc intensity of heart sounds of right side during inspiration
inc RV preload
4th heart sound S4 freq/time/side
heard best w _____ dz
produced by
indicates
rhythm
low freq, late diastolic/both
cardiac hypertrophy
bell of steth
atrial contraction into stiff, noncompliant ventricle
TEN-NES-SEE (S4-S1-S2)
Murmur
due to
Valve structure pathologic, occurs in
high freq sounds involve
best heard w ____ side of steth
Lower pressure sounds dz
best heard w
inc flow
exercise, anemia, hyperthyroidism, pregnancy
LV systolic pressure (AS/AR/MR)
diaphragm
MS/Right side valve path
bell
Pericardial friction rub
dz association
sounds
3 components
pericarditis
rough, sandpaper w 3 components
atrial contraction, ventricle systole, early disatole
Rheumatic MS time/location
pt position, side of scope?
Sound Preceding _____ in early diastole
Then _______ murmur due to atrial contraction, producing flow across _____
early diastole rumble, apex
LL decubitus, bell
sharp opening snap in early diastole (MV under pressure)
presystolic(late diastolic) murmur due to atrial contraction producing flow across stenotic valve
Second heart sound S2 freq, reflects
process of valves
Inc splitting of S2 result of
such as _____ dz states
wide caused by ______ dz
all should lead to
Wide split S2 that does not vary w the cycle (fixed)
high freq, closing of A/P valves
A2 before P2 (physiologic splliting v LV depolarization 1st)
delayed ejection of RV
inspiration, RBBB, PS
MR, early aortic valve closure
varied width of split w resp cycle
ASD
S2
DO w delayed LV ejection
result, and when severe
PHTN produces (S2)
Mechanical aortic valve produces (S2)
LBBB, AS
dec splitting of S2, paradoxical (inc during expiration)
inc S2 (due to louder P2)
very loud S2
3rd heart sound S3 (AR)
freq, heard best w
produced by
indicates
Side, differentiated by
Rhythm
low freq, bell of steth
rapid, early ventricular filling of dilated ventricle (early diastole)
cardiac dilation
Both, location/Carvallo’s sign
KEN-TUCK-Y (S1-S2-S3)
