Cardiology Flashcards
Why do we time the heart sounds with the carotid/radial pulse when auscultating?
To differentiate between S1 and S2, especially in rapid heart rates. S1 occurs at the same time/slightly after the pulse. S2 occurs in between pulse beats.
In normal heart beats, the cadence of the beat can distinguish S1 from S2. As diastole takes twice as long as systole, there is a longer pause between S2 and the next S1 than between S1 and S2. However, rapid heart rates can shorten diastole making it more difficult to tell the difference between S1 and S2
What type of murmur coincides with the pulse?
Systolic
What type of murmur occurs between pulse beats?
Diastolic
Which murmurs are systolic?
Aortic stenosis (ejection systolic)
Mitral regurgitation (pansystolic)
Tricuspid regurgitation (pansystolic)
Which murmurs are diastolic?
Aortic regurgitation (early diastolic)
Mitral stenosis (mid-diastolic)
What is digoxin and what is its indication?
- Digoxin is a cardiac glycoside
- Indicated in treatment of chronic heart failure and persistent AF (rate control through action of AV node)
- Works by increasing cardiac contractility and controlling heart rate
Atrial fibrillation vs atrial flutter
- AF= atria beat irregularly
- Atrial flutter= atria beat regularly but faster than usual and more often than the ventricles, so you may have four atrial beats to every one ventricular beat
- Atrial flutter is less common than AF
- 1/3 of people with atrial flutter also have AF
- Both have increased risk of stroke so need anticoagulation therapy (DOAC or warfarin)
What are the 2 main ways of treating AF and when do you use each type?
- Rate control= controlling the ventricular rate but accepting the abnormal rhythm
- Rhythm control= attempting to maintain patient in normal sinus rhythm
- Persistant AF= manage with rate- control (esp. if patient less symptomatic)
- Intermittent (paroxysmal)/ highly symptomatic AF/ history of cardiomyopathy= rhythm-control (usually in addition to rate-control)
