Cardio Findings

Question 1

Aortic stenosis signs

Answer 1

Narrow pulse pressure, anacrotic/plateau pulse Afib Pressure loaded apex beat (forceful, sustained) Mid/Ejection systolic murmur. Radiates to carotids Louder expiration Quieter isometric handgrip and valsalva Quiet second heart sound Signs severity -Plateau pulse, -Aortic thrill, -Longer duration, -Quiet second heart sound -4th Heart sound -LVF (RVF preterminal)

Question 2

Tricuspid regurgitation signs

Answer 2

-JVP= large v waves, elevated if RV failure -RV heave on palpation -Pansystolic murmur, loudest at lower end of sternum on inspiration. Quieter w valsava Louder w isometric handgrip -Pulsatile, large and tender liver +/- ascites, oedema w pleural effusions

Question 3

Pulmonary hypertension signs

Answer 3

Dominant a wave palpable p2 Right ventricular impulse Loud P2 (pulmonary component of second heart sound) Pulmonary regurgitation Tricuspid regurgitation

Question 4

AS w AR signs

Answer 4

Bisferiens pulse

Question 5

Aortic regurgitation signs

Answer 5

Collapsing pulse Volume loaded apex (forceful, not sustained) Diastolic murmur Loudest over left lower sternal edge on full expiration Signs Severity -Collapsing pulse, wide pulse pressure -Longer decrescendo murmur - Third heart sound -Soft A2 (aortic component second heart sound) -Austin flint murmur- diastolic rumble -LVFailure

Question 6

Mitral regurgitation signs

Answer 6

Volume loaded apex beat (forceful, not sustained) Pansystolic murmur to apex. Radiates to axilla Louder w isometric handgrip Quieter w valsalva Signs severity -Enlarged LV +/- LVF -Pulmonary HTN (late) -Soft first heart sound +/- Third heart sound -Small volume pulse

Question 7

Mitral stenosis signs

Answer 7

Tapping apex beat Mid-Late diastolic murmur Signs severity -small pulse pressure, -Early opening snap (raised LA pressure), -Longer duration of murmur, -Pulmonary HTN

Question 8

HOCM signs

Answer 8

Pulse- sharp rising or bifid carotid impulse JVP- prominent a wave Double/triple impulse apex beat Late systolic ejection murmur at left sternal edge, +/- pan systolic murmur at apex= MR +- fourth heart sound Louder w Valsalva Quieter w isometric handgrip Quieter w squatting

Question 9

Mitral Valve prolapse signs

Answer 9

Late systolic click murmur Louder w isometric handgrip Louder w valsalva more women not always with MR A/W marfans, atrial septal defect

Question 10

Pulmonary stenosis signs

Answer 10

-Peripheral cyanosis and low volume pulse because of low cardiac output. -JVP- large a waves due to right atrial hypertrophy, JVP elevated -RV heave, thrill over pulmonary area -Murmur (harsh systolic murmur, loudest at pulmonary area on inspiration), +/- preceded by ejection click. +/- S4 Quieter w valsava Louder w isometric handgrip -Presystolic liver pulsation

Question 11

Chronic constrictive pericarditis signs

Answer 11

Cachectic, ascites Low BP, pulsus paradoxus Raised JVP Impalpable apex bet Distant heart sounds+/- early third heart sound +/- pericardial` knock Hepatosplenomegaly, ascites, oedema

Question 12

Atrial septal defect signs

Answer 12

fixed splitting of second heart sound, pulmonary systolic ejection murmur increasing on inspiration, late sign= pulmonary hypertension

Question 13

Ventricular septal defect signs

Answer 13

o Thrill + harsh pansystolic murmur at left sternal edge +- mitral regurgitation.

Question 14

PDA signs

Answer 14

Continuous murmur, listen left under clavicle

Question 15

Diastolic murmur grade

Answer 15

1= barely audible 2= audible, soft 3= easily audible 4= loud

Question 16

Systolic murmur grade

Answer 16

1= barely audible 2= audible, soft 3= easily audible 4= easily audible w thrill 5= loud w thrill and barely steth to chest 6= loud w thrill, no steth