hemodynamics Flashcards
Ms. ArdMr. Ass
mitral sten & aortic regurg : diastolicmitral regurg & aortic sten : systolic
pulsus tardus
delayed pulse to carotids because heart is beating harderassociated with aortic stenosis
water hammer pulse
associated with aortic regurg
de musset’s sign
head bob with heart beatassociated with aortic regurg
quincke’s pulse
alternating flush/pallor in nail bedsassociated with aortic regurg
traube’s sign
pistol shot sound, femoral arteryassociated with aortic regurg
low, listen with bell
S3, S4, summation gallop, mitral stenosis, tricuspid stenosisS34, SMarT
mitral stenosis associated s/s
won’t open therefore back up: coarse crackles, dyspnea, orthopnea, PNDa fib because atrium struggling - NO ATRIAL KICK
what happens to chambers that get regurged into?
dilation - they can’t get it out
this valve problem results in LV hypertrophy, dilation, failure
aortic regurgitation(PMI shifts left, fatigue, SOB, syncope, exercise intolerance)
increased risk with aortic regurg
increased CHF risk (PMI shifts left, fatigue, SOB, syncope, exercise intolerance)
commissure
two leaflets abnormally stuck to each other
no atrial kick with what valve issue
mitral stenosis
may hear a click with late systolic murmur
mitral valve prolapse
mitral regurg results + s/s
decreased SV, L atrial dilationexaggerated PMI, dyspnea, orthopnea, PND, dysphagia (enlarged left atrium), PVC, SVT
aortic stenosis s/s
angina (poor coronary artery perfusion)syncopeexertional dyspneaexaggerated PMIpulsus tardus
exaggerated PMI in which valve problems
mitral regurgitation (LV dilated)aortic stenosis (can’t get blood out)
valve issue intensifies with dehydration
mitral valve prolapse
tricuspid stenosis
usually occurs with systemic problem resulting in mitral stenosis and also some sort of aortic problem
physiological splitting S2: what & heard where
↑ venous return to RV = late pulmonic closure↓ return to LV d/t ↑ pulmonary capacity (inspiration) - early aortic closureheard: pulmonic
heart sound highly suggestive of myocardial failure
summation gallop
S3
ventricular galloppassive filling of blood into non-compliant LVbell on mitral (left lateral may help)
S4
atrial gallopblood enters non-compliant LV during atrial kickbell on mitral (left lateral may help)
if you have a fib, which heart sound will you NOT hear?
S4
murmur grades
I - softII - think about itIII - no duhIV - murmur + thrillV - louder but needs stethoscope + thrillVI - no stethoscope needed + thrill
systolic vs diastolicejection vs regurgitation
systolic:
aortic regurg aka
aortic insufficiency
PAC picks up pressure as v wave from which valve problem?
mitral regurgitation
low decrescendo-crescendo
mitral stenosis
high holosystolic
mitral regurgitation
medium harsh diamond
aortic stenosis
high blowing decrescendo
aortic regurg
mean arterial pressure is
average pressure in the arteries throughout the cardiac cycle
- depends on
- the elastic properties of the arterial walls
- mean volume of blood in arterial systems
pulse pressure is
difference between systolic and diastolic pressures
- directly r/t arterial wall stiffness + SV
cerebral perfusion pressure is
net pressure gradient required to perfuse brain cells
