Cardiovascular/Peripheral Vascular Flashcards
Active cancer, history of recent immobilization, or recent travel are risk factors for:
DVT
Chest pain occurring either at rest or with activity and does not change with respiratory or position, may radiate to L arm/neck and typically lasting more than 20 minutes
Acute coronary syndrome
Pain radiating to both arms, left arm, jaw or neck are symptoms of:
Acute coronary syndrome
PAST or current history of smoking is a major risk factor for:
Peripheral artery disease
HTN, smoking, preeclampsia, and family history are significant risk factors for?
Cardiovascular disease
Recent evidence shows that women present with more subtle symptoms than men for?
CVD or ACS
Presence of AV nicking, hemorrhages, papilledema or exudates on fundoscopy are signs of end organ damage associated with?
Long standing OR uncontrolled HTN
Displacement of PMI, clicks, murmurs, S3/S4 heart sounds may be seen with?
Long standing OR uncontrolled HTN
Most COMMON cause of calf pain with activity, relieved with rest
Peripheral artery disease
The physical findings of hairless lower extremities and atrophic skin is associated with?
Peripheral artery disease
Indicates the beginning of systole and coincides with the apical pulse?
S1
Indicates the beginning of diastole?
S2
The type of murmurs that occur between S1 and S2
Systolic murmurs
The type of murmurs that occur between S2 and S1
Diastolic murmurs
Used to evaluate cardiac electrical conduction
EKG
May demonstrate wave form changes (P, ST, T) indicative of ischemia/infarction
EKG
Murmurs associated with mitral stenosis and aortic regurgitation are these type of murmurs
Diastolic
Aortic stenosis, mitral regurgitation, and tricuspid regurgitation are these types of murmurs
Systolic
Represents the CVP or pressure in the RA
JVP
Raising the head of the bed, turning the head away from the examiner, using a tangential light across the neck will assist with assessing..
JVP
What heart sound indicates ventricular failure or an MI d/t an abrupt deceleration of blood flow across the mitral valve?
S3
When does S3 occur in auscultation?
After S2
What heart sound indicates a ventricular dysfunction?
S4
When does S4 occur in auscultation?
Right before S1
Are S3 and S4 diastolic or systolic murmurs?
Diastolic
This sound occurs due to the closing of the aortic and pulmonic valves occurring at different times. If it occurs during inspiration d/t increased pressure in the aorta it is physiologic and if it persists during exhalation it is a pathologic (fixed) sound.
S2 split
Where is the mitral valve best heard?
The apex
Where is the tricuspid valve best heard?
The L sternal border
Harsh sounding, crescendo-decrescendo, mid-systolic murmur heard best at the R 2nd/3rd intercostal space with the patient sitting/leaning forward
Aortic stenosis
Rumbling, low decrescendo, diastolic murmur, heard best at the apex with the bell with the patient in a L lateral position
Mitral stenosis
Blowing, high pitched, diastolic murmur, best heard at the L 2nd-4th intercostal spaces with the patient sitting/leaning forward and holding their breath after exhalation
Aortic regurgitation
Hard, medium/high pitched, holosystolic murmur, best heard at the apex that does not vary with respirations
Mitral regurgitation
Blowing, medium pitched, holosystolic murmur, best heard at the lower L sternal border that increases with inspiration
Tricuspid regurgitation
Harsh, crescendo-decrescendo, mid-systolic mumur, best heard at the L 2nd/3rd intercostal spaces
Pulmonic stenosis
Which murmurs are diastolic?
S3/S3, mitral stenosis, aortic regurgitation
Which murmurs are systolic?
Aortic stenosis, pulmonic stenosis, mitral regurgitation, tricuspid regurgitation
SBP-DBP=?
Pulse pressure
Key findings:
normally asymptomatic pt, pulsatile abdominal mass, bounding pulse, pain in region of mass that doesn’t change with movement if symptomatic, syncopal episodes
AAA
Key findings:
Hx of HLD and smoking; normally asymptomatic, moderate-severe diagnosis accompanied by angina, TIAs/CVAs, HTN, bruits, weak pulses, elevated inflammatory markers, A-BI <0.9 or >1.4
Atherosclerosis
Key Findings:
FH of ASD, Holt-Oram syndrome, trisomy 21, Noonan’s syndrome; wide fixed S2 split, cardiomegaly, NSR with possible prolonged QT
Atrial septal defect
Key Findings:
Hx of prolonged sitting/standing, obesity, physical inactivity, elderly, females, pregnancy; aching, heaviness, itching, edema to LE, varicose veins, hyperpigementation
Chronic venous insufficiency
Key Findings:
FH of coarctation, Hx of Turner’s syndrome, DiGeorge’s syndrome; gallop rhythm, CHF s/s, weak femoral pulses, skin mottling
Coarctation of the aorta
Key Findings:
fatigue, anorexia, nausea; Hx AMI or LVH; weakness, arrhythmias, dyspnea with exertion, ascites, LE edema, JVD, cough with white/pink tinged exudate, weight gain, elevated ANH/BNP
CHF
Key Findings:
FH of CVD/HTN, Hx of diabetes, obesity/overweight, physically inactive, smoking/ETOH use, unhealthy diet (excessive salt/saturated fat); primarily asymptomatic, can present with headaches, nosebleed
HTN
Key Findings:
fever, chills, malaise, dyspnea, cough, joint pain, petechaie, sublingual hemorrhages, dark-red linear lesions of the nail beds, Osler’s nodes, Janeway lesions, delirium, rales, gallops, pericardial friction rub
Infective endocarditis
Key Findings:
primarily asymptomatic, mid-systolic click, chest pain, fatigue, dyspnea on exertion, anxiety, palpitations
Mitral valve prolapse
Key Findings:
Hx of acute trauma; CP worsened by breathing/lying, tachypnea, NP cough, fever >100.4, chills, weakness, pericardial friction rub
Pericarditis
Key Findings:
Female, color changes to digits with cold/stress, vasospasms
Raynaud’s
Key Findings:
Hx of untreated strep throat or rheumatic fever; pathologic heart murmur, joint pain/arthritis symptoms, CP or swelling
Rheumatic heart disease
Key Findings:
Varying degrees of cyanosis resolved by bringing knees to chest; Hx of DiGeorge’s syndrome, Trisomy 21, 18, or 13, Holt-Oram syndrome, alagille’s syndrome
Tetralogy of Fallot
Key Findings:
Hx Trisomy 21, 18, or 13, Holt-Oram syndrome; maternal marijuana, cocaine, or paint stripping use; noted loud holosytolic or short systolic ejection murmur
Ventricular septal defect
What is the leading cause of sudden death in athletes?
Hypertrophic cardiomyopathy
When does the heart fully form in a fetus?
Day 35 of gestation
What is a tool used to predict DVT probability?
Wells Criteria
If an S1 split is heard, this could be from…
RBBB or PVCs
A fixed S2 spilt indicates…
Atrial septal defect, RV failure
A wide S2 split (not fixed) indicates…
Pulm. stenosis with a RBBB or aortic valve early closure with MVR
EKG leads II, aVF, and III are _______ leads
inferior
EKG leads aVL, I, aVR are _______ leads
lateral
