Common Terms in Cardiology

Question 1

White coat hypertension

Answer 1

• Three clinic-based blood pressures > 140/90 mmHg

- Two non-clinic-based blood pressures

Question 2

Orthostatic hypotension

Answer 2

Fall in SBP > 20 mmHg or DBP > 10mmHg in response to change in posturefrom a supine to upright position within 3 minutes

Question 3

Resistant hypertension

Answer 3

Blood pressure consistently >140/90 mmHg despite >3 antihypertensive agents, including a diuretic

Question 4

Chronotropic incompetence

Answer 4

• Failure to appropriately increase heart rate during exercise
• Unable to achieve 85% of predicted maximal heart rate at peak physical exercise

Question 5

Stable angina pectoris

Answer 5

• Chest discomfort associated with physical exertion or stress
• Relieved within 5-10 minutes of rest and/or sublingual nitroglycerin

Question 6

Unstable angina

Answer 6

Angina pectoris with at least one of three features:

1. Occurs with minimal exertion or at rest, usually lasting >10 minutes
2. Severe and of new onset (within the prior 4-6 weeks)
3. Has a crescendo pattern (i.e. distinctly more severe, prolonged, or frequent than previous)

Question 7

Abdominojugular reflux

Answer 7

• Apply pressure on right upper quadrant for 10 sec

- Positive response: rise of >3cm of JVP for at least 15 seconds after release of pressure

Question 8

Carvallo’s sign

Answer 8

Holosystolic murmur of tricuspid regurgitation becomes louder with inspiration and diminishes during expiration

Question 9

Gallavardin effect

Answer 9

• Murmur of aortic stenosis is transmitted downward to the apex
• Confused with the systolic murmur of mitral regurgitation

Question 10

Graham Steell mumur of pulmonary regurgitation

Answer 10

• High-pitched, diastolic, decrescendo blowing murmur along the left sternal border due to the dilation of the pulmonary valve ring
• Occurs in mitral valve disease and severe pulmonary hypertension

Question 11

Pulsus parvus et tardus

Answer 11

Weak and late peripheral pulse in aortic stenosis

Question 12

Corrigan’s pulse

Answer 12

• A rapidly rising “water-hammer” pulse

- Collapses suddenly as arterial pressure falls rapidly during late systole and diastole

Question 13

Quincke’s pulse

Answer 13

• Capillary pulsations

- Alternate flushing and paling of the skin at the root of the nail while pressure is applied to the tip of the nail

Question 14

Traube’s sign

Answer 14

A booming “pistol-shot” sound heard over the femoral arteries

Question 15

Duroziez sign

Answer 15

To-and-fro murmur audible over the femoral artery

Question 16

Broadbent’s sign

Answer 16

Apical pulse is reduced and may retract in systole (in constrictive pericarditis)

Question 17

Ewart’s sign

Answer 17

Patch of dullness and increased fremitus below the left scapula due to pericardial effusion

Question 18

Kussmaul’s sign

Answer 18

Rise of lack of fall in JVP with inspiration due to constrictive pericarditis

Question 19

Pulsus paradoxus

Answer 19

Fall in SBP >10 mmHg with inspiration associated with cardiac tamponade

Question 20

Homan’s sign

Answer 20

Calf pain on dorsiflexion of foot, suggestive of deep vein thrombosis

Question 21

Hamman’s sign

Answer 21

Crunching noise synchronous with the heart beat in pneumomediastinum