Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Prep > Cardiology > Flashcards

Cardiology Flashcards

1
Q

Causes of loud 1st heart sound

A

Mitral stenosis
Tricuspid stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Causes of soft 1st heart sound

A

Mitral regurgitation
RBBB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Causes of loud 2nd heart sound (aortic)

A

hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Causes of soft 2nd heart sound (aortic)

A

aortic stenosis, aortic regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Causes of loud 2nd heart sound (pulmonary)

A

pulmonary hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Causes of soft 2nd heart sound (pulmonary)

A

pulmonary stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What causes increased normal splitting of the second heart sound?

A

RBBB, pulmonary stenosis, mitral regurgitation
(Aortic closing early or pulmonary closing late)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes fixed splitting of second heart sound?

A

ASD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes reversed splitting of second heart sound?

A

LBBB, severe aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the mechanism of the third heart sound?
What are the causes?

A

tautening of mitral or tricuspid cusps at the end of rapid diastolic filling

  • LV 3rd = louder at apex in expiration, LV failure, AR, MR, VSD, patent ductus arteriosus
  • RV 3rd = left sternal edge in inspiration, RV failure, constrictive pericarditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the mechanism of the fourth heart sound?
What are the causes?

A

high atrial pressure wave reflected back by poorly compliant ventricle

  • LV 4th= AS, MR, hypertension, IHD, HOCM
  • RV 4th= pulmonary hypertension, pulmonary stenosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Systolic murmurs

A

Left - MR (pansystolic), AS (ESM), HCM (valsalva)
Right - TR, PS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Diastolic murmurs

A

Left - AR, MS
Right - PR, TS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Continuous murmurs

A

PDA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Causes of Mitral stenosis

A

Calcific, rheumatic, post mitral valve repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Clinical signs of MS severity

A
  1. Small pulse pressure
  2. Early opening snap
  3. Long diastolic rumbling
  4. Diastolic thrill at apex (rare)
  5. Presence of pulmonary hypertension
    a. Prominent A-wave on JVP
    b. RV impulse
    c. Loud P2 / palpable P2
    d. Pulmonary regurgitation
    e. Tricuspid regurgitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MS investigations

A

Investigations
- ECG – p-mitrale, AF (chronic), RV systolic overload, right axis deviation
- CXR – MV calcification, big left atrium, pulmonary hypertension, signs of cardiac failure
- Echo – colour mapping across Mitral valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MS indications for surgery

A

Indications for surgery
- Exertional dyspnoea + MV area <1cm + evidence of increased right heart pressures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mitral regurgitation causes

A
  1. Degenerative
  2. Mitral valve prolapse
  3. Rheumatic (usually associated with MS murmur)
  4. Papillary muscle dysfunction (LVF or ischaemia)
  5. Connective tissue disease (ank spon, RA)
  6. Congenital – including corrected transposition of the great arteries
20
Q

MR signs of severity

A

Signs of severity
1. Enlarged LV
2. Pulmonary hypertension (late sign)
3. 3rd heart sound
4. Soft first heart sound
5. Split S2 (aortic early)
6. LVF

21
Q

MR investigations

A

Investigations
1. ECG – p-mitrale, LV overload, right axis deviation
2. CXR – large LA, increased LV size, pulmonary hypertension
3. ECHO – leaflet morphology (thickened, calcific), LA size, LV size and function, mapping of regurgitant jet, estimation of pulmonary pressures

22
Q

MR indications for surgery

A

Indications for surgery
- Class 3 or 4 symptoms
- LV dysfunction

23
Q

Aortic regurgitation - causes / associations

A

Valvular - rheumatic, congenital (bicuspid valve), seronegative arthropathy
Aortic root - marfans, aortitis, dissecting aneurysm, old age

24
Q

Marfans
- mode of inheritance
- gene most common
- disease manifestations

A

autosomal dominant
fibrillin 1
arachnodactyly, joint hypermobility, narrow face, lens disclocation, high arched palate, pectus excavatum / carinatum, AR + MV prolapse, arm-span

25
Q

AR - signs of severity

A
  1. collapsing pulse
  2. wide pulse pressure
  3. long decrescendo diastolic murmur
  4. third heart sound
  5. LV failure
26
Q

AR - investigations

A

ECG - LVH
CXR - LV dilatation, aortic root dilatation or aneurysm, valve calcification
Echo - LV dimensions and function, doppler estimate of regurgitant jet, aortic root dimensions

27
Q

AR - indications for surgery

A
  1. exertional SOB
  2. worsening LV function
  3. progressive LV dilatation on serial echocardiograms (LV end-systolic dimension of >5.5cm)
28
Q

Aortic stenosis - causes

A

degenerative
rheumatic
calcific bicuspid valve

29
Q

Aortic stenosis - clinical signs of severity

A
  1. plateau pulse
  2. length, harshness, lateness of the peak of the systolic murmur
  3. Aortic thrill
  4. 4th heart sound
  5. paradoxical splitting of the second heart sound (delayed LV ejection and aortic valve closure)
  6. LV failure (late sign)
30
Q

Aortic stenosis - investigations

A

ECG - LVH
CXR - LVH, valve calcification
Echo - AVA <1cm, gradient >40mmHg, velocity 4m/s

31
Q

Aortic stenosis - indications for surgery

A

exertional symptoms
critical obstruction even if asymptomatic

32
Q

Life expectancy of a bioprosthetic valve

A

15 years

33
Q

Tricuspid regurgitation - clinical signs

A
  1. JVP - V-waves
  2. RV heave
  3. pansystolic murmur maximal at lower end of the sternum and on inspiration
  4. multiple systolic clicks are assocaited with Ebstein anomaly
  5. Pulsatile and tender liver, ascites and peripheral oedema
34
Q

Tricuspid regurgitation - causes

A
  1. functional (RV failure causing dilatation)
  2. Rheumatic
  3. IE (esp. IVDU)
  4. Congenital - Ebstein’s anomaly
  5. RV papillary muscle infarction
  6. Pacemaker or defibrillator lead
  7. Trauma (steering wheel to sternum)
35
Q

Tricuspid regurgitation - investigations

A

CXR - right ventricular enlargement
ECHO - size of jet, and gradient

36
Q

Pulmonary stenosis - causes

A

congenital
carcinoid syndrome

37
Q

Pulmonary stenosis - clinical signs

A

Signs of low LV cardiac output:
- peripheral cyanosis, small volume pulse
Signs of RV overload / failure:
- RV heave, thrill over pulmonary area, hepatic congestion, S4

Severe = late peaking systolic murmur, S4 or right heart failure signs

38
Q

What is Kussmaul’s sign
What is it a sign of?

A

Increased JVP with inspiration
Constrictive pericarditis

39
Q

Constrictive pericarditis clinical signs

A

Low BP, pulsus paradoxus
Elevated JVP
Apex beat is not palpable
Distant heart sounds
Hepatosplenomegaly, peripheral oedema

40
Q

Constrictive pericarditis causes

A

radiation, tumour, post cardiac surgery, tuberculosis, connective tissue disease, chronic renal failure

41
Q

Hypertrophic cardiomyopathy signs

A
  1. pulse - sharp rising / jerky pulse
  2. JVP - prominent a wave
  3. double or triple impulse of the apex beat
  4. Auscultation: late ejection systolic murmur at left sternal edge, pansystolic murmur at apex from mitral regurgitation
  5. 4th heart sound
  6. Dynamic manoeuvres - louder with valsalva and standing. Softer with squatting or isometric exercise.
42
Q

HCM - investigations

A

ECG - LVH and lateral ST segment / t-wave changes
- deep Q waves
CXR - LV hump, absence of valve calcification
ECHO - asymmetric hypertrophy, systolic anterior motion of the MV leaflet, LVOT gradient

43
Q

VSD - clinical signs
- disease associations

A

Harsh pansystolic murmur confined to left sternal edge
Associated with trisomy

44
Q

Patent ductus arteriosus
- where does blood shunt to and from
- clinical signs

A

from the aorta to the pulmonary artery
Continuous murmur (often mistaken for AS with AR)

45
Q

How do you differentiate Eisenmenger syndrome from tetralogy of fallot?

A

Eisenmenger has pulmonary hypertension

Clinical Prep (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions