Concepts in Cardiac Assessement- Tyler Flashcards
S3 is normal sound in ______
kids
What causes the S1 sounds?
closure of mitral valve
S3 and S4 are (diastolic/systolic) sounds?
diastolic
What type of split S2 describes delayed closure of pulmonic valve on INSPIRATION?
Wide physiologic split
What type of split S2 describes prolonged ventricular systole?
fixed splitting
What type of split S2 describes closure of aortic valve after P2 on EXPIRATION?
paradoxical split
What heart sound reflects atrial contraction into non compliant ventricle?
S4
What heart sound (S1,2,3,4) do you expect to hear in aortic stenosis and hypertrophic cardiomyopathy?
S4
What heart sound (S1,2,3,4) do you hear with LV failure?
S3
Tricuspid Regurg and VSD can be heard in which of the following
a. LLSB
b. RUSB
c. Left midclavicular line
d. LUSB
a. LLSB
Grade the following murmur: loud with palpable thrill?
4/6
Grade the following murmur: very faint, may not be heard in all positions
1/6
Grade the following murmur: moderately loud, NO THRILl
3/6
Grade the following murmur: very loud with thrill, can be heard with stethoscope entirely off chest?
6/6
What is the classic triad of aortic stenosis?
SAD
syncope, angina, dypnea
Common cause of aortic stenosis, especially in older poeple?
calcific valve degeneration
Decreased carotid pulse (parvus e tardus) is noted for which murmur on PE ?
aortic stenosis
Aortic stenosis gets LOUDer with __________?
squatting
Systolic crecendo-decrescendo , harsh murmur, radiates to sternal notch?
Aortic Stenosis
Medical therapy is not enough to treat ______ (murmur) instead, surgical intervention provides more survival.
aortic stenosis
ACUTE aortic regurg has two types _______ +________
native & prosthetic
Native acute AR is caused by what 3 things?
- endocarditis
- typeA dissection
- Trauma
Prothetic acute AR is caused by what 3 things?
- tissue leaflet rupture
2 paravavular regurg - mechanical valve closure problem
(Acute/ Chronic) AR presents with pulmonary edema and low CO?
ACUTE
(Ac cercise tolerance ?
Chronic
(Acute/ Chronic) AR is caused by rheumatic fever, aortic root dilation, or endocarditis?
Chronic
(Acute/ Chronic) AR is due to valve deformity?
chronic
Diastolic Decrescendo, high pitched murmur at LSB?
aortic regurg
Must monitor pts with AR using ECHO to follow ______size and function?
Left ventricular
Avoid vasodilator for _______ and use vasodilators for _______(AR/AS)?
- AS
2. AR
Tricuspid regurg is a result of ______ dilation
right ventricular
IV drug abusers will have _________ (murmur)
Tricuspid regurg
Systolic Holosystolic blowing murmur LSB ?
Tricuspid Regurg
Unlike VSD, __________(murmur) increases with inspiration? (Both are heard at LLSB)
Tricuspid Regurg
Large jugular V waves are indicative of -__________ (murmur)
TR
Diastolic Low pitch, rumbling, with opening snap?
mitral stenosis
The MORE sever the Mitral stenosis the _______ (smaller/larger) the s2-OPening snap interval?
SMALLER
The s2-OS interval is _________ proportional to the severity of MS
inversely (more severe= smaller interval)
Most common cause of Mitral stenosis?
rheumatic fever
What is the triad of CXR findings for mitral stenosis?
- prominent Pulm artery vascularity
- enlarged LEFT atrium
- normal size LV
Systolic , upper LSB, fixed split of S2?
ASD
Enlarged RV, Right axis deviation and RBBB on EKG are findings associated with _______ (murmur)
ASD ( right sided, because ASD causes volume load increase on RIGHT side)
Patient with ASD often develops __________ (arrythmia)
atrial fibrillation
Most common heart defect in children?
VSD
systolic, holosystolic murmur with thrill at LLSB ?
VSD
Continuous machine like murmur at LUSB?
PDA
