CVS PHYSIOLOGY Flashcards
What is pulse
It is pressure wave originating in aorta due to ejection of blood during LV systole and travels along arterial wall at 5m/s
Parameters of assess performance of LV
Stroke volume
Velocity of ejection
Waves of pulse
Percussion wave Anacrotic notch Tidal wave DN dicrotic notch Dicrotic wave
Wave representing
LV ejection
Aortic recoil
Peripheral resistance
P wave
T wave
D wave
Artery where character and contour are best felt
Carotid
Upstroke of pulse coincide with what in phonogram
S1 and peak occurs before S2
Pulse wave velocity depends on
Stroke volume
Importance of arterial stiffness
Reflect true arterial damage
Predictor of Cardiovascular status
Marker of early TOD
Best marker in HTN
What happens to pulse wave in aged people
Stiffness of arterial wall reduces vessel wall cushioning so pulse wave velocity increases
Difference between stiff and compliant vessel
Pulse wave velocity increases in stiff while decrease in compliant
Reflected wave will arrive early in stiff vessel and DBP will be low leading to decrease Coronary perfusion
Stiff vessel augments SBP
Radio femoral delay is present in
Coarctation of aorta
Change in pulse from central to periphery
Carotid to femoral
Upstroke becomes deeper
Anacrotic notch becomes less apparent
Dicrotic notch becomes smoother
Sinus tachycardia is seen in
It is heart rate more than 100 Seen in Sepsis Hypovolemia Myocarditis Cardiogenic shock (Ant wall MI) High output state
Sinus bradycardia is seen in
Beta blocker Myxedema Hypothermia Increased ict Inferior wall MI
Faget sign
It is seen in
Relative bradycardia ie with rise in body temperature heart rate decreases
Causes
Typhoid, Legionella, Q fever, Scrub Typhus
Drug fever, Lymphoma
Rapid regular pulse is seen in
Supraventricular & Ventricular tachycardia
Irregularly irregular and Regularly irregular pulse can be seen in
Irregularly irregular - A fib, A flutter, A tachycardia
Regularly irregular- Ventricular premature complex
High volume pulse is characterized by
Amplitude of upstroke high
Dicrotic wave less prominent
High CO
Low PR
Example where high volume pulse with low cardiac output is seen
Complete heart block -SV increase but HR decrease
Elderly due to arterial stiffness
Waterhammer pulse is defined as
It is seen in
Brish upstroke Large amplitude Rapid descent Seen in AR Aortic sinus rupture PDA
Pulsus tardus is seen in
Its mechanism
Severe AS
Upstroke slow, peak delay
Ejection velocity increased but volume doesn’t increase leading to decreased lateral pressure
Slow rise of wave
2peak in systole is seen in
Pulsus bisferiens
Severe AR
AR with mild AS
HCM
Pulsus parvus et tardus
Seen in very severe AS
LV failure low peak slow rise
What is dicrotic pulse
Mechanism
Seen in
2 peaks one in systole and other in diastole
Increase peripheral resistance leading to prominent dicrotic pulse
Seen in
LV dysfunction, cardiac tamponade
Mechanism of pulsus bisferiens in hypertrophy cardiomyopathy
Rapid rise of pulse due to hypercontracility of ventricle
Systolic anterior motion of mitral leaflet, obstruct ejection
