Cardiovascular Flashcards
Location of the apex beat
5th left ICS or within 1-2cm medial to MCL or 7-9cm lateral to MSL
S1 is due to
Closure or mitral and triscuspid valve
Exertional chest pain with radiation to the left aide of the neck down to the arm
Angina pectoris
Sharp pain radiating into the back or into the neck
Aortic dissection
Chest pain that improves when leaning forward
Pericarditis
Transient skips and flipflops
Premature contraction
Rapid regular beating of sudden onset and offset
Paroxysmal supraventricular tachycardia
Orthopnea suggest
Left ventricular heart failure
Mitral stenosis
Significant right to left shunting at the level of the heart or lung
Central cyanosis
Tender raised nodules on the pars of fingers or toes
Ouchler
Osler’s nodes
Non tender, slightly raises hemorrhage on the palms and soles
Janeaway
Linear petechiae in the mid position of the nail bed
Splinter hemorrhage
Due to the presence of right to left shunting
Clubbing
genetic disorder with atrial septal defect
Holt oram syndrome
Reflects right atrial presystolic contraction
Preceding S1
A wave
Defines the fall in right atrial pressure after inscription of the a wave
X descent
Interrupts this x descent and is followed by a further descent
C wave
Represents atrial filling (atrial diastole)
Occurs during ventricular systole
V wave
What does the JVP reflext
Right atrial pressure
An increase in JVP suggest what
Right sided heart failure
Prominent A wave signifies what
Tricuspid stenosis
Hypertrophied RV
Absent A wave
Atrial fibrillation
Level of pulsation usually descends with inspiration
Kussmaul sign
Where is the atrial pulse best appreciated
Carotid level
Delayed carotid upstroke weak
Aortic stenosis
Sharp rise and rapid fall off
Corrigans
Water hammer pulse
Hypertrophic cardiomyopathy
Bifid pulse
If the apical impulse is not detected, what do you do next
Use the bell at the apex in left lateral decubitus
In what condition is the PMI displaced upward and to the left
Pregnancy
High left diaphragm
Lateral displacement could be due to what
CHF Cardiomyopathy Ischemic heart disease Displacement of the thorax Mediastinal shift
An increase of amplitude may signify what
Hyperthyroidism
Severe anemia
Aortic stenosis
Mitral regurgitation
Sustained high amplitude impulse that is normally located
Hypertension
Sustained low amplitude
Dilated cardiomyopathy
Palpable brief middiastolic impulse
S3
Palpable impulse just before the systolic apical beat
S4
Marked increase in amplitude with little or no change in duration
Atrial septal defect
When is S2 palpable
Pulmonary hypertension
Ejection sounds or systolic clicks
Extra sounds of systole
Physiologic S3 and S4
Athletes
Sounds like kentucky
Pathologic S3 or ventricular gallop
Mitral valve prolapse
Squatting can delay it
Standing moves it closer to S1
Systolic click
Indicate valvular disease but can be normal
Systolic murmur
Harsh and machinery like quality
PDA
Quality can be obliterared by pressure
Venous hum
