Cardiology 2 Flashcards
mid-late diastolic murmur loudest on expiration
Loud S1 with opening snap
Diagnose
Mitral stenosis
L subclavicular thrill
Machinery murmur
large volume, bounding, collapsing pulse
wide pressure pulse
Diagnose
PDA
Wide pulse pressure
Cannon waves on JVP
Variable intensity S1
Diagnose
CHB
How do thiazide diuretics work
inhibit sodium reabsorption at the beginning of the DCT by blocking the thiazide-sensitive Na+-Cl− symporter
SE of thiazide diuretics
Low K+
Low Na
High Ca
Impaired glucose tolerance
ED
Gout
If pulses paradoxus is present what could that indicate
severe asthma
tamponade
slow rising pulse
AS
collapsing pulse
Aortic Regurg
PDA
hyperkinetic states (anaemia, thyrotoxic, fever, exercise/pregnancy)
pulse alternans
severe LVF
bisferiens pulse
mixed aortic valve disease
jerky pulse
HOCM
40 yo female
SOB, CP on exertion, cyanosis, HTN
OE JVP with a waves
Diagnosis and management
Pulmonary Artery Hypertension
Acute vasodilator testing
-ve: prostatglandin analogues
endothelial receptor antag
+ve: CCB
Endocarditis following dental procedure organism
Streptococcus viridans
Endocarditis following operation (non dental) organism
Staphylococcus epidermidis
Endocarditis in patient with colorectal cancer, organism
Streptococcus bovis
- subtype Streptococcus gallolyticus
Large A wave
Tricuspid Stenosis/Pulmonary Stenosis
pulmonary HTN
Absent A wave
AF
What does A wave on JVP show
Atrial contraction
What does cannon A wave represent
Atrial contraction against closed valve
What causes cannon A wave
reg: VT AVNRT
ireg: CHB
What does c wave show
Closure tricuspid
not normally visable
What does v wave show
filling of blood into the atrium against a closed tricuspid valve
Giant V wave
Triscuspid regurg
What does y wave show
tricuspid opening
What does rise in JVP during insp indicate?
Kussmals sign
constrictive pericarditis
Loud S1
Mitral stenosis
Soft S1
long PR or mitral regurgitation
Soft S2
aortic stenosis
When would S3 be considered normal?
< 30 years old (may persist in women up to 50 years old)
S3 >50yo
LVH
MR
Constrictive pericarditis
S4
Aortic stenosis, HOCM, HTN
67 year old admitted SOB
PHx: COPD
ECG: narrow complex tachy, 3 P wave morphologies
Diagnosis and management
Multifocal atrial tachycardia
CCB
48h post MI
CP worse on lying flat
diagnosis
pericarditis
1 week post MI
SOB, raised JVP, quiet heart sounds
diagnosis
LV free wall rupture
1 week post MI
acute MR and pansytolic mumur
diagnosis
Ventricular septal defect
Post MI persistent ST elevation with no CP
LV aneurysm
4 weeks post MI
fever, pleuritic pain and effusion
Diagnosis and management
Dresslers
NSAIDS
Post MI
hypotension, pulm oedema, early mid diastolic murmur
acute MR due to papillary muscle ischaemia/rupture
Patient with Turners
Soft ES murmur
bicuspid aortic valve
Resp depression following IV Mg
management
Calcium Gluconate
Which med is CI in VT
verapamil
Which med is CI in HOCM
ACE-I
