Heart Exam Flashcards
The sound we hear from S1 is caused by?
closure of the mitral valve (beginning of ventricular contraction)
the sound we hear from S2 is caused by?
closure of the aortic valve (beginning of ventricular relaxation)
what does the S8 heart sound mean for young patients? old patients? when would we hear it?
it can be normal in young children and some young adults. in older adults can mean changes in ventricular compliance
we can hear it after S2
describe what S4 is and when we hear it
vibration on the ventricular wall due to atrial contraction, proceeds S1 of the next beat. it means a change in ventricular compliance
describe stenosis
valve doesn’t open all the way and not enough blood passes through
describe regurgitation
valve doesn’t close all the way so blood leaks backwards
how do we perform a heart exam?
inspection: check for cyanosis (is pt oxygenating well? do they have SOB?) and obtain PMI
perform palpations and obtain PMI
perform auscultation (on skin): place at right 2 ICS, then left 2 ICS, then left 4 ICS, then left 5 ICS
the 2nd right ICS identifies the?
aortic area
the 2nd left ICS identifies the?
pulmonic area
the lower left ICS identifies the?
tricuspid area
the apex (lower right) ICS identifies the?
mitral area
S2 is louder than S1 at the?
base (upper portion of heart)
S1 is louder than S2 at the?
apex (bottom portion of heart)
hydrochlorothiazide
lisinopril
Prinivil, Zestril
lovastatin
mevacor
niacin
niacor
lower cholesterol
nitroglycerin
nitrostat
metoprolol
lopressor, toprol XL
losartan
cozaar
meclizine
bonine
treats motion sickness and vertigo
lamotrigine
lamictal
seizures and bipolar
metoclopramide
reglan
antiemetic: GERD
what does TEE stand for?
transesophageal echocardiogram
what does TTE stand for?
transthoracic echocardiogram
what does IE stand for?
infective endocarditis
what does CPR stand for?
cardiopulmonary resuscitation
what does ACLS stand for?
advanced cardiovascular life support
what does ACS stand for?
acute coronary syndrome
what does CHD stand for?
coronary heart disease
what does CAD stand for?
coronary artery disease
what does CHF stand for?
congestive heart failure
what does CVD stand for?
cardiovascular disease
what does JVP stand for?
jugular venous pressure
what does PMI stand for?
point of maximal impulse
define pericardiectomy
excision of membrane surrounding the heart
define cardiomegaly
an enlarged heart
define sonogram
image produced by reflected sound
define electrocardiogram
tracing of electrical activity of heart during the cardiac cycle
define regurgitation
backflow of blood through a defective heart valve
define thrills
a vibration felt with palpation due to turbulent flow
define murmur
whooshing sound from blood passing through heart
what are echocardiograms used for?
to produce images produced by sound waves to identify heart structure, beating, blood flow in chambers, and valve function
what can an electrocardiogram be used to determine?
heart rate, rhythm, ischemia, or heart attack
what is the holter monitor used for?
shows us 24-48 hours of EKG
what are cardiac event monitors used for?
to determine any heart abnormalities associated with rhythm
what is a coronary angiography/angiplasty?
when you inject dye to visualize heart blood vessels, determine blockages or narrowing areas, or diagnose and/or treat blood vessel disease
when plaque forms in the lining of the artery leading to blood clots and limited blood flow, what would we diagnose the pt with?
coronary artery disease
how can we diagnose coronary artery disease?
EKG, ECHO, exercise stress testing, or cardiac angiography/angioplasty
how can we treat coronary artery disease?
lifestyle modifications, antihypertensives, statins, and manage comorbidities
what is the presentation of angina?
chest pain with SOB, syncope, fatigue, diaphoresis (sweating), or nausea
describe stable angina
brought on by exertion, relieved by rest or vasodilator
describe unstable angina
occurs at rest, will increase in frequency and not relieved by rest or vasodilator
describe prinzmetals angina
uncommon pattern occurring at rest and caused by coronary artery spasms
what are the common heart attack warning signs (myocardial infarction)
pain/discomfort in chest
lightheadedness, nausea, or vomiting
jaw, neck or back pain
discomfort or pain in arm or shoulder
shortness of breath
what does a STEMI look like on an EKG?
elevated ST segment
what does a non-STEMI look like on an EKG?
depressed ST segment
what are the med treatment for MI? (MONA)
morphine
oxygen
nitrates
aspirin
what are the leading causes of HF?
HTN and CAD
what are signs of HF?
crackles, peripheral edema, tachycardia, and cardiomegaly (enlarged heart)
what is infective endocarditis?
inflammation of the endocardium - infection of the heart valves
what are signs of infective endocarditis?
fever, new or altering heart murmur