Heart murmurs Flashcards
Machinery like murmur
Patent ductus arteriosus, PDA
Early diastolic with High pitched quality,
Louder when pt is sitting and leaning forward (at the Base of the heart)
Aortic regurg
Base of heart, what murmurs would be heard?
Aortic
Pulmonic
Tx for Dilated Cardiomyopathy
ACE-I and B blocker
Person w hx of Cocaine use, coming in with Dilated Cardiomyopathy
found unconscious
50% of DCM recover spontaneously, and someone w hx of cocaine use should NOT be given B-blocker
wean off oxygen
4 main types of shock
Cardiogenic
Hypovolemic
Distributive
Obstructive
Ventricular Septal Defect
-blood flowing between ventricles thru the septum
Normal life expec
but inc risk of bacterial endocarditis
Unique trait a/w VSD- ventricular septal defect
The smaller the defect, the LOUDER the murmur (bc the greater the gradient from L to R ventricle)
What do you use to Close PDA-patent ductus arteriosus
Indomethacin
ASD- atrial septal defect
Definitive tx: Close defect surgically
Large shunt or Heart failure: diuretic, digoxin, ACE-I before surgery
HCTZ (thiazide diuretic) to tx HTN is a/w
Hypokalemia
(low K)
muscle weakness, cramping, heart arrhythmia, kidney abn, glucose int
IVDU Endocarditis
Tricuspid valve
Tx w Vancomycin
after trauma, SOB and Muffled heart sounds
think Pericardial Tamponade
Aortic regurg
Wide pulse pressure
Tachycardia
High pitched murmur, loudest at Left sternal border
Loude`r when leaning forward
Which type of Cardiomyopathy is a/w Radiation
Restrictive Cardiomyopathy, RCM
Restrictive Cardiomyopathy is referred to as
Radiation Cardiomyopathy
more common in pts w hx of Breast or Lung CA that have underwent Radiation to thoracic area
Restrictive Cardiomyop has signs of which side Heart failure
Right sided Heart Failure
peripheral edema
ascites
Harsh, pansystolic murmur in an A-sx baby
VSD- ventricular septal defect
Given at therapeutic doses, _______ can reduce Cholesterol levels
Nicotinic acid
Which artery does the Ophthalmic artery branch off of?
Internal carotid
Amaurosis Fugax
transient Monocular vision loss d/t Retinal clot or Reduction of blood flow from Retinal, Ophthalmic, or Ciliary artery
Monocular vision loss lasting a few min w Complete recovery
Amaurosis fugax
problem w Ophthalmic artery which branches off of Internal carotid
What can cause Mitral Regurg
Ichemia following a Myocardial Infarction
About 25% of pts that get surgery for Coarcation of the Aorta then have
HTN
d/t changes in the RAAS system
Post surgery for Coarctation of the Aorta
HTN
Disproportionate systolic HTN w exercise
What risks do ppl who have had surgery to repair Coarctation of the Aorta now have?
Re-coarctation
Aortic aneurysm
LVH
What monitoring do those with surgical repair of Coarcation of Aorta need?
BP monitor!
if high, treat aggressively
What is Coarctation of Aorta
Narrowing of the Aorta
Sx of Coarc of Aorta
Often no sx until adulthood, adult presents with HTN
Excessive alcohol use is a/w which type of Cardiomyopathy
Dilated cardiomyopathy
S3 gallop
Heart failure
6 week old infant
Turns blue all over when feeding or crying
Cyanosis of lips when crying
RVH
Tetralogy of Fallot
Most common Cyanotic Congenital Heart defect
Tetralogy of Fallot
4 components of Tet of Fallot
Ventricular Septal Defect- VSD
Pulm Artery stenosis
Overriding aorta (displaced to the R)
Right Ventricle Hypertrophy
VSD- hold b/w ventricles
Pulm artery stenosis- pulm artery is hard
Overriding aorta- aorta is displaced to the R
RVH
Tet of Fallot
Tet of Fallot
Hole in ventricles
Pulm artery is hard
Aorta is to the R
R Ventricle is big
Gradual onset of reduced exercise tolerance
3/4 Diastolic murmur best heard at APEX
Mitral stenosis
Apex valves would be
Mitral
Tricuspid
Diastolic rumbling murmur best heard at apex
Mitral stenosis
Harsh, low pitched Crescendo-decrescendo SYSTOLIC murmur starting after S1
Aortic Stenosis
K sparing diuretic
Amiloride
so if pt w HF has low K levels, can add this one
Sx you may see with Coarc of Aorta (other than HTN)
Rib notching
Notch in aorta
Higher BP in upper extremities than lower
Delay b/w brachial and femoral pulses
Systolic ejection murmur
