Day 4 - CV2 Quiz Flashcards
CXR pericardial effusion
Globular/watterbottle shaped heart (similar to DCM)
PE pericardial effusion
Diminished heart sounds, difficult to palpate apical impulses
Kussmaul sign
Increased JVD w/ inpsiration; Most commonly constrictive pericarditis; Restrictive CM, Right ventricular infarct, Massive PE; Rarely, with cardiac tamponade
Signs of HF, DM, elevated LFTs
Triad = Hemochromatosis (restrictive CM); Bronze diabetes
Restrictive CM etiology, reversed w/ phlebotomy
Hemochromatosis
Next step in w/u low grade systolic murmur in healthy, asymptomatic pt
Usually benign, so Observation; If symptomatic or sx of valvular disease - Echo
Next step in w/u diastolic murmur in healthy, asymptomatic pt
Echo
Short systolic murmur at cardiac apex, decrease w/ squatting, sometimes assoc w/ benign chest pain last a few seconds
MVP (also may have mid-systolic click); Also assoc. w/ anxiety
Valve disorder from heumatic disease may become sx/pronounced when
Volume overload state (e.g., pregnancy)
HF in young patients
Myocarditis (e.g., coxsackievirus, echovirus)
Beck’s triad
Hypotension, distended neck veins, muffled heart sounds; Cardiac tamponande
CHF Drugs
ACEi/ARB; Beta blocker; Loop diuretic; Spironolactone/Eplerenon; Maybe digoxin; ASA
Acute HF
LMNOP = Lasix, Morphine, Nitrates (sometimes, Nesiratide), Oxygen, Positioning/Pressors (e.g., Dobutamine)
Diastolic murmur heard best at LL sternum, increases w/ inspiration
Tricuspid stenosis
Late diastolic murmur w/ opening snap, No change w/ inspiration
Mitral stenosis
Systolic murmur heard best in 2nd right intercostal space
Aortic stenosis
Systolic murmur heard best in 2nd left interspace
Pulmonic stenosis
Late diastolic murmur heard best at apex
MVP
Diastolic murmur w/ widened pulse pressure
AR
Holosystolic murmur loudest w/ inspiration heard at LLS
Tricuspid regurgitation
Holosytolic murmur heard best at apex and radiates to axilla
Mitral regurgitation
