CARDIO/EKG Flashcards
PR Interval > 0.2 seconds
asymptomatic, no tx
First degree AV block
lengthening PR intervals until a ventricular beat is dropped “longer longer longer drop”
-PR interval resets itself
asymptomatic, no tx
Second degree Mobitz type 1 block, wenckebach
PR interval constant before an “occasional” dropped QRS beat.
-some p waves do not produce QRS
**referred for permanent pacemaker
Second degree AV block, Mobitz 2
P waves and QRS complexes, but NO association between the two (no association btw atria/ventricles)
*medical emergency, emergent meds: atropine
Third degree AV block, Complete heart block
EKG leads V1-V2, SEPTAL
LAD
EKG leads V3-V4, ANTERIOR
LAD
EKG leads I, aVL, V5, V6- LATERAL
Left Circumflex
EKG leads II, III, aVF- INFERIOR
Right Coronary
EKG leads V1-V3, posterior leads V7-V9- POSTERIOR
Posterior descending artery
Holosystolic High pitched
Loudest at apex, radiate to axilla
Mitral valve regurgitation
Holosystolic High pitched
Loudest at LLSB
Tricuspid valve regurgitation
crescendo-decrescendo systolic ejection
Loudest at heart base radiating to carotids
Aortic stenosis
Holosystolic, harsh sounding murmur
Loudest at LLSB
VSD
Late systolic crescendo with mid systolic click
best heard over apex
MVP
High pitched early diastolic blowing decrescendo murmur
-pulsation of uvula orally: Muller sign
-pulsation of capillaries in fingernails w/ pressure: Quincke sign
-pulsating pistol shot heard over femoral arteries: Traube sign
-rapidly rise/falling arterial pulse w/ wide pulse pressure: Corrigan/ water hammer pulse
Aortic Regurgitation
Opening snap with delayed rumble, late diastolic
Mitral stenosis
Continuous machine like murmur
best heard at left infraclavicular area
PDA
Systolic murmurs
MVR
TVR
AS
VSD
MVP
Diastolic murmurs
AR
MS
enhanced with expiration
Mitral stenosis
enhanced with hand grip (3)
AR
VSD
MVR
click occurs with valsalva or standing
MVP
enhanced by inspiration
TVR
DECREASED by valsalva
AS
enhanced by squatting AND hand grip
MVR
rheumatic heart disease (JONES) is result of immune mediated damage to what cardiac valve
secondary to streptococcal derived M protein activation of T and B lymphocytes (anti-streptolysin ab, elevated streptozyme titers)
Mitral valve
what is the best dx test for pulmonary embolism/blood clot
CT pulmonary angiography
decrease SBP >20, DBP >10
INC HR >10
when going from supine to standing, from hypovolemia, drugs, autonomic insufficiency
orthostatic syncope
no drop in BP from sit –> stand
cough, sneeze bring on fainting spell
emotion tied to it, tunnel vision
“common faint”
Vasovagal syncope
HR <60 / min
bradycardia
HR >100/ min
tachycardia
regular sinus rhythm at rate <60/min
P wave before every QRS
normal PR and QRS intervals
sinus bradycardia
normal sinus rhythm at rate 60-100 /min
P wave before every QRS
normal PR and QRS intervals, T waves
normal sinus rhythm
