Cardiovascular Flashcards
What causes an S3 heart sound, and when would it occur in the cardiac cycle?
Caused by a rapid rush of blood into a dilated ventricle, during early diastole; ventricular gallop, ‘kentucky’
Common causes of an S3 heart sound:
HF, pHTN, mitral/aortic/tricuspid insufficiency
What causes an S4 heart sound, and when would it occur in the cardiac cycle?
Caused by atrial contraction of blood into a non-compliant ventricle, during diastole just before S1
Common causes of an S4 heart sound:
myocardial ischemia, infarction, HTN, ventricular hypertrophy, AORTIC STENOSIS
What is pulse pressure and what is the normal range?
systolic - diastolic = pulse pressure
normal: 40-60 mm Hg
What do systolic and diastolic blood pressure approximate ?
SBP - indirect measure of CO + SV
DBP - indirect measure of SVR
During what part of the cardiac cycle are the coronary arteries perfused?
Diastole
Which valves are open during diastole?
mitral + tricuspid (open during ‘fill’ time)
Which valves are open during systole?
pulmonic + aortic (open during ‘eject’ time)
What type of murmurs are heard during systole?
-AV stenosis
-Pulmon. valve stenosis
-MV insuff/regurg
-TV insuff/regurg
-VSD
What type of murmurs are heard during diastole?
- AV insuff/regurg
- Pulmon insuffic/regurg
- MV stenosis
- TV stenosis
Which murmur can result from ongoing atrial fibrillation?
mitral stenosis s/t atrial enlargement
What murmurs might result from an acute MI?
- Mitral regurg ( s/t papillary muscle dysfunction/rupture–medical emergency)
- VSD
List some atypical symptoms of MI (commonly seen in women, pt’s > 75 y.o., diabetics).
- nausea
- SOB
- extreme fatigue
- syncope/falls
- acute delirium
What distinguishes a STEMI and NSTEMI?
NSTEMI – positive trop, ST depression, T wave inversion, unrelenting CP
STEMI – positive trop, ST elevation in 2 or more contiguous leads, unrelenting CP
What are the features of unstable angina?
negative trop, CP at rest, unpredictable CP that may be relieved w/ nitro, ST depression or T wave inversion
Describe variant/Prinzmetal’s angina.
- transient ST elevation
- caused by coronary artery spasm (may or may not be atherosclerotic)
- negative troponin
- nitro helps
- occurs at rest
When would you not give beta-blockers for acute chest pain?
- ACS related to cocaine use
- hypoTN, bradycardia
- taking phosphodiesterase inhibitors
Changes in leads II, III, aVF indicate an MI where?
- RCA
- inferior LV
Changes in leads V1, V2, V3, V4 indicate an MI where?
- LAD
- anterior LV
Changes in V5, V6, I, aVL indicate an MI where?
- circumflex
- lateral LV
Changes in V5, V6 indicate an MI where?
- low lateral LV
Changes in I, aVL indicate an MI where?
- high lateral LV
Changes in V1, V2 indicate an MI where?
- RCA
- posterior lV
