Cardiology

Question 1

What defines a Class I NYHA for CHF

Answer 1

No limitation of physical activity.

Ordinary physical activity doesn’t cause fatigue or SOB

Question 2

What defines a Class II NYHA for CHF

Answer 2

Slight limitation of physical activity.
Comfortable at rest.
Ordinary physical activity results in fatigue and SOB

Question 3

What defines a Class III NYHA for CHF

Answer 3

Marked limitation of physical activity.
Comfortable at rest.
Less than ordinary activity causes fatigue and SOB

Question 4

What defines a Class IV NYHA for CHF

Answer 4

Unable to carry on any physical activity.
Discomfort at rest.
Any physical activity causes discomfort

Question 5

What defines a Class A NYHA for CHF

Answer 5

No evidence of CVD. No sx, no limitations with ordinary physical activity

Question 6

What defines a Class B NYHA for CHF

Answer 6

Minimal CVD. Mild sx and slight limitations during ordinary activity.
Comfortable at rest

Question 7

What defines a Class C NYHA for CHF

Answer 7

Moderately severe CVD. Marked limitation in activity, even during less than ordinary physical activity.
Comfortable only at rest

Question 8

What defines a Class D NYHA for CHF

Answer 8

Severe CVD. Severe limitations

Sx at rest

Question 9

Mid-Systolic, Crescendo-Decrescendo murmur heard best at right Sternal border that radiates to carotids

Answer 9

Aortic Stenosis

Question 10

PanSystolic, Blowing murmur, heard best at apex that radiates to axilla

Answer 10

Mitral Regurgitation

Question 11

PanSystolic, Blowing murmur, heard best at left sternal border.
Murmur increases in intensity with inspiration.

Answer 11

Tricuspid Regurgitation

Question 12

Mid-Systolic Ejection Click heard best at apex

Answer 12

Mitral Valve Prolapse

Question 13

Diastolic Descresendo Blowing Murmur heard best at left upper sternal border
Wide pulse pressure
Bounding Pulses
Water Hammer Pulse

Answer 13

Aortic Regurgitation

Question 14

Mid-Diastolic, Rumble, heard best at apex
Opening Snap
No radiation

Answer 14

Mitral Stenosis

Remember: SNAP=STENOSIS

Question 15

What are the 4 features of Tetralogy of Fallot

Does it cause Cyanosis?

Answer 15

Ventral-Septal Defect
Pulmonary Artery outflow obstruction (narrowing/Stenosis)
Right Ventricular Hypertrophy
Overriding Aorta
Yes-Causes Cyanosis

Question 16

What types of things increase a murmur

What is the exception

Answer 16

Inspiration increase all murmurs except for Hypertrophic Cardiomyopathy
Inspiration = Laying Down = Squatting

Question 17

What types of things decrease a murmur

What is the exception

Answer 17

Expiration decreases all murmurs except for Hypertrophic Cardiomyopathy
Expiration = Standing = Valsalva

Question 18

What is Pericardial Tamponade
What defines it (sx)
Tx

Answer 18

A pericardial effusion causing significant pressure on the heart that results in restricted ventricular filling and decreased CO
Beck’s Triad: Distant, Muffled Heart Sounds, Increased JVP, Systemic Hypotension
Also see Pulsus Paradoxus
Tx: Immediate Pericardiocentesis (Pericardial window if recurrent)

Question 19

Systolic Ejection Crescendo-Decrescendo flow murmur head best at pulmonic area
Widely split fixed S2 that doesn’t vary with respiration

Answer 19

Atrial Septal Defect

Question 20

Continuous Machine-like Murmur heard best at pulmonic area

Wide pulse pressure with bounding peripheral pulses

Answer 20

Patent Ductus Arteriosus

Question 21

Systolic murmur that radiates to the back/scaupla chest
BP is higher in upper extremities when compared to lower extremities
Delayed, weak, femoral pulses

Answer 21

Coarctation of Aorta

Question 22

Harsh Holosystolic murmur heard best at left sternal border
Blue Baby Syndrome
Tet Spells

Answer 22

Tetraology of Fallot