CLINICAL - Clinical Presentation of Cardiorespiratory Patients Flashcards
What are the two normal heart sounds in small animals?
S1
S2
What are S1 heart sounds?
S1 is the ‘lub’ sound caused by the closure of the atrioventricular (AV) valves
What are the S2 heart sounds?
S2 is the ‘dub’ sound caused by the closure of the aortic and pulmonic valves
What is a heart murmur?
A heart murmur is an abnormal heart sound due to turbulent blood flow
What are the five categories you should use to describe a heart murmur?
Timing
Intensity
Location
Quality
Pitch
What is the timing of a heart murmur?
The timing of a heart murmur refers to when during the cardiac cycle the murmur is heard
What is a systolic murmur?
A systolic murmur occurs between the S1 and S2 heart sounds
Pay attention to the sound of the systolic murmur
What is a diastolic murmur?
A diastolic murmur occurs between the S2 and S1 heart sounds
What is a continuous/machine murmur?
A continuous/machine murmur is continuous throughout the cardiac cycle
Machine murmur sound: https://www.msdmanuals.com/professional/multimedia/audio/patent_ductus_arteriosus_murmurs
What is the intensity of a heart murmur?
The intensity of a heart murmur is how loud the murmur is
This is classified based on a scale from I to VI
What is a grade I heart murmur?
Very soft murmur heard only in a quiet room after a period of concentrated listening
What is a grade II heart murmur?
Murmur audible as soon as the stethoscope is appropriately placed over the point of maximal intensity (PMI)
What is a grade III heart murmur?
Murmur as loud as the normal heart sounds. Heard easily from a distance from the point of maximal intensity (PMI), but not generally on the contralateral side of the chest
What is a grade IV heart murmur?
Murmur louder than the normal heart sounds. Sound radiates widely beyond the point of maximal intensity (PMI) and can be heard on the contralateral side of the chest
What is a grade V heart murmur?
Very loud murmur associated with a palpable precordial thrill
What is a grade VI heart murmur?
Very loud murmur with a precordial thrill that can be detected even without the stethoscope
What can make it challenging to properly assess the intensity of a heart murmur?
Obsese patients can make it challenging to accurately assess the intensity of a heart murmur as the extra layers of far can obscure the murmur intensity
What is the location of a heart murmur?
The location of a heart murmur refers to where you can hear the loudest point of the heart murmur
Where should you auscultate to hear the pulmonic valve?
Left sided base of the heart
Where should you auscultate to hear the aortic valve?
Left sided base of the heart
Where should you auscultate to hear the mitral valve?
Left sided apex of the heart
Where should you auscultate to hear the tricuspid valve?
Right apical side of the heart
What is the quality of a heart murmur?
The quality of a heart murmur refers to the ‘shape’ of a heart murmur
What kind of murmur is indicated by this murmur quality?
Plateau murmur
What kind of murmur is indicated by this murmur quality?
Crescendo-decrescendo murmur
What kind of murmur is indicated by this murmur quality?
Decrescendo murmur
What is the pitch of a heart murmur?
The pitch of a heart murmur describes the auscultators perception of the frequency of the murmur
What is an arrhythmia?
An arrhythmia is a variation from the normal cardiac rhythm
Which diagnostic test should you do to confirm diagnosis if you have auscultated an arrhythmia?
ECG
What is sinus rhythm?
Sinus rhythm is a regular rhythm characterised by a montonous S1 and S2 cadence
What is a sinus arrhythmia?
Sinus arrhythmia is a regulalrly irregular rhythm associated with a variation in intensity of vagal tone when an animal breathes
In which species is sinus arrhythmia generally normal?
Dogs
Why would you be more concerned if you heard sinus arrhythmia in a cat?
Cats are often stressed when at the vets and thus will have high sympathetic tone so it would generally be abnormal to hear sinus arrhythmia as they will have low vagal tone when at the vets
What is atrial fibrillation?
Atrial fibrillation is a rapid, irregularly irregular rhythm with a variable intensity of heart sounds
What is pulse pressure?
Pulse pressure is the difference between systolic and diastolic pressure
What is indicated by a high pulse pressure?
A high pulse pressure indicates there is a wide difference between the systolic and diastolic pressure
What is indicated by a low pulse pressure?
A low pulse pressure indicates there is a small difference between the systolic and diastolic pressure