Cardio Exam Flashcards
How does performing a valsalva maneuver effect murmurs?
It increases the volume of murmurs due to HCM and mitral valve prolapse
What extra technique can be performed if IE is suspected?
Palpate for the spleen
What is the difference between a thrill and heave?
Thrill is a palpable murmur
A heave is caused by a ventricular contraction
When do you test for hepatojugular reflux?
If the JVP isn’t otherwise visible
If you can’t see the JVP rise and fall with inspiration
What happens to venous return during inspiration?
Inspiration > Thoracic wall expands > Increase negative pressure > Expansion of the vena cava’s and RA > Increase blood flow into RA
Which murmurs are louder during inspiration? Why?
Right sided
Because venous return is greater during inspiration
In what position in MS hear best?
With the patient lying on their left side
What are the two waves of the JVP and what do they represent?
A: R atrial contraction
V: R ventricular contraction
Why are left sided murmurs softer doing inspiration?
Inspiration > Expansion of lungs and pulmonary tissues > Increased blood volume in pulmonary vessels > Decreased return to LA and LV > Softer murmurs
What is Duroziez’s sign?
Femoral bruit (pistol sound) indicating aortic regurg
Which cohort of patients are more likely to demonstrate A waves in their JVP?
Older patients with stiffer great veins that don’t absorb the atrial contraction pressure
