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(OMS2) PCM III Final > Final: Concepts in Cardiac and Heart Sounds DSA > Flashcards

Final: Concepts in Cardiac and Heart Sounds DSA Flashcards

1
Q

What can cause a fixed split S2?

A

Usually an ASD, but R HF can cause it too

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2
Q

What is the most common cause of a delayed A2 that moves closer to P2 on inspiration?

A

LBBB is the main cause of paradoxical splitting

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3
Q

When is an S3 sound heard?

A

Normal in children, in adults its due to volume overload and dilated cardiomyopathy

D=S3

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4
Q

What does an S4 sound mean?

A

Atrial contraction against a non-compliant ventricle

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5
Q

When would you hear an S4?

A

Ventricular hypertrophy in:

  • Aortic stenosis
  • HTN
  • Hypertrophic cardiomyopathy
  • CAD
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6
Q

What pathology would cause an opening snap followed by a diastolic rumble?

A

Mitral stenosis

-usually due to rheumatic heart disease

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7
Q

Mid systolic click followed by a late systolic murmur?

A

Mitral valve prolapse

-common in younger women and Marfans

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8
Q

What grade of murmur: a very faint murmur, that youd have to listen for 5-6 beats while being tuned it?

A

Grade 1

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9
Q

What grade of murmur: Quite, but still heard after a few beats?

A

Grade 2

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10
Q

What grade of murmur: moderately loud, no thrill

A

Grade 3

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11
Q

What grade of murmur: moderately loud, with thrill

A

Grade 4

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12
Q

What grade of murmur: loud, thrill, heard with stethoscope partly off chest

A

Grade 5

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13
Q

What grade of murmur: very loud, heard without stethoscope

A

Grade 6

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14
Q

This pathology is the most common murmur in elderly. Due to abnormal calcification. Presents as cresendo-decresendo systolic murmur that radiates to the neck. You may also hear an S4 gallop.

A

Aortic stenosis

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15
Q

What can cause aortic stenosis in those less than 50?

A

Bicuspid aortic valve

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16
Q

What is the classic triad of aortic stenosis?

A

HF, angina, and syncope

17
Q

What is an Austin-Flint murmur?

A

It is due to rheumatic heart disease where you have both an AS and MS murmur

18
Q

Can you treat AS with vasodilators?

A

No, actually can make it worse. Usually valve replacement is the first choice

19
Q

This murmur is an early diastolic decresendo murmur. Heard best at the left sternal boarder (3rd space)

A

Aortic regurge

20
Q

What are some common causes of aortic regurge?

A

Endocarditis (valve deformity) and Type A dissection
-expect cardiogenic shock symptoms!

Also syphilis

21
Q

What can chronic AR cause?

A

LV hypertrophy and volume overload, leading to left heart failure

22
Q

What is treatment of choice for aortic regurge?

A

ACEi/ARBs + diuretics

23
Q

This murmur is a holosystolic murmur that radiates to R sternal boarder that increases in intensity with inspiration.

A

Tricuspid regurge.

24
Q

What are 2 common causes of tricuspid regurge?

A
  1. RV dilatation due to pulmonary HTN** or Left HF
  2. Acute endocarditis (staph aureus and IVDU)

also look out for carcinoid syndrome and ebstein anomaly

25
Q

What conduction abnormality is common with mitral stenosis?

A

A-fib

26
Q

How does the duration of time b/t S2 and the opening snap of MS compare to the severity of disease?

A

They are inversely related!

-the more severe the disease, the higher the LA pressure, the early the opening snap will be heard

27
Q

What would a chest x-ray show on someone with a MS show?

A
  1. Prominent pulmonary artery vascularity
  2. An enlarged LA
  3. Normal sized LV
28
Q

What is the most common congenital heart disease diagnosed in adulthood (after bicuspid aortic valve)?

A

An Atrial septal defect

29
Q

If I said a systolic ejection murmur at LSB that causes a fixed split between P2 and A2, and can lead to A-fib?

A

ASD

30
Q

What is the most common congenital defect in kids?

A

VSD

31
Q

Do smaller or larger VSDs produce murmurs?

A

Smaller ones

-have to force the blood through a smaller hole

32
Q

If I said a continuous, machine-like murmur that is heard at the LUSB and causes cyanosis of the LE and Pulmonary HTN, what would you say?

A

PDA

33
Q

What is a rapid rise and fall with an elevated systolic and low diastolic pressure found in radial or brachial pressures a sign of?

A

Chronic aortic regurge

(OMS2) PCM III Final (4 decks)

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