CPS case 4 Flashcards
presystolic murmur
mitral or tricuspid stenosis
holosystolic murmur (pansystolic)
mitral or tricuspid regurgitation or of ventricle septal defect
aortic ejection murmur
ejection click, and fading before the second heart sound heard
systolic murmur in pulmonic stenosis
spilling through aortic second sound, pulmonic valve closure being delayed
S1
mitral and tricuspid valve closure
S2
aortic/pulmonic valve closure
S3
early ventricular filling
S4
late ventricle filling (atrial contribution)
S3 can be heard
best at apex
- after S2 during rapid ventricular filling
- normal in children and young adults
pathological causes of S3 heart sound
- excessive rapid filling with normal compliance
- high output states
- mitral regurgitation
- normal filling rate with decreased compliance or increased ESV
- hypertrophic cardiomyopathy
- left-ventricular dysfunction
when can continuous murmur be heard?
patent ductus arteriosus
unstable angina
non occlusive
non specific on ECG
normal cardiac enzymes
NSTEMI
occluded thrombus sufficient to cause tissue damage and mild myocardial necrosis
- ST depression +/- T wave inversion on ECG
- elevated cardiac enzymes
STEMI
complete thrombus occlusion
- ST elevations on ECG or new LBBB
- elevated cardiac enzymes
- more severe symptoms
some causes for left axis deviation
LV hypertrophy
LBBB
inferior wall MI
hyperkalemia
