Cardiovascular Flashcards
Malar flush - associated with?
Mitral stenosis
Finger clubbing causes - CVD?
- Infective endocarditis
- Congenital cyanotic heart disease
- Atrial myxoma
Collapsing pulse - caused by?
Normal physiology (fever, pregnancy)
Cardiac lesions (aortic regurgitation, patent ductus arterosis)
High output states (anaemia, AV fistula, thyrotoxicosis)
Slow rising brachial pulse - associated with?
Aortic stenosis
Bounding brachial pulse - associated with?
Aortic regurgitation
CO2 retention
Thready brachial pulse - associated with?
Intravascular hypovolaemia (in eg. sepsis)
Narrow pulse pressure - causes?
- Aortic stenosis
- Congestive heart failure
- Cardiac tamponade
Wide pulse pressure - causes?
- Aortic regurgitation
- Aortic dissection
Causes of raised JVP - CVD?
- Right sided heart failure
- Tricuspid regurgitation
- Constrictive pericarditis
High arched palate - associated with?
- Marfan syndrome -> mitral/aortic valve prolapse and aortic dissection
Heaves - associated with?
Right ventricular hypertrophy
How to accentuate aortic regurgitation?
Lean forward and listen with diaphragm during expiration
Murmur of aortic regurgitation
Early diastolic murmur
How to accentuate mitral regurgitation?
Roll patient onto left side and listen over mitral area with diaphragm during expiration - continue into axilla to listen for radiation
Murmur of mitral regurgitation?
Pansystolic murmur
Accentuate for mitral stenosis?
With patient on left hand side listen over mitral area using bell during expiration
Murmur of a mitral stenosis?
Mid-diastolic murmur
Coarse crackles =?
Pulmonary oedema
Ischaemic rubour?
A dusky red discolouration of the leg that typically develops when the limb is dependent
How to perform burgers test?
- with patient supine - stand at bottom of bed and raise both legs to 45 degrees for 1-2 mins
- Observe for colour change in limb - if pallor occurs note which angle this is (burgers angle)
- Sit the patient up and ask them to hang their legs down over the side of the bed
Further assessments at end of Peripheral vascular exam?
- Blood pressure
- Cardiovascular examination
- ABPI measurement
- Upper and lower neurological limb exam (if neurological deficit identified)
Further assessments at end of cardiovascular exam?
- Measure BP
- Peripheral vascular exam
- Record a 12 lead ECG
- Dipstick urine (HTN)
- Bedside cap glucose (CVD RF)
- Fundoscopy (HTN)
Characteristics of venous eczema?
- Itchy red, blistered plaques
- Atrophie blanche
- Orange brown pigmentation patches
- Lipodermatosclerosis
What is atrophie blanche?
- star-shaped ivory white depressed atrophic plaques with red dots within he scar
-Due to haemosiderin deposition
What is lipodermatosclerosis?
- skin hardening (induration)
- Hyperpigmentation
- Erythema
- Swelling
- Inverted champagnebottle appearance
What is a saphena varix?
Dilation of the saphenous vein at its junction with the femoral vein in the groin
Where is a saphena varix?
Lump around 2-4cm inferior-lateral to the public tubercle
Where does the great saphenous vein run?
Medial side of leg
Where does the small saphenous vein run?
Posterior aspect of the leg
Causes of aortic stenosis?
Common: Degenerative calcification of aortic valve, bicuspid aortic valve
Uncommon: Rheumatic heart disease, congenital heart disease
Investigations into aortic stenosis?
- ECG
- CXR
- Transthroacic echo
- Coronary angiogram (in case bypass surgery required at same time of valve replacement
