PACES__Cardiology Flashcards
A narrow pulse pressure is associated with what valvular pathology?
A wide pulse pressure is associated with what valvular pathology?
Narrow=AS
Wide=AR
You should suspect what condition in a young patient with an intracardiac device?
HCM
What does a heave on examination represent?
A dilated and/or hypertrophied ventricle
What does a thrill represent?
A palpable murmur
What is Corrigan’s sign? What valvular pathology does it represent?
-Visible accentuated carotid artery pulsation
-AR
What valvular pathology do CV waves correspond to?
TR
Is the apex beat displaced or undisplaced in AS?
Undisplaced
Is the apex beat displaced or undisplaced in AR?
Displaced
Is the apex beat displaced or undisplaced in MS?
Undisplaced
Is the apex beat displaced or undisplaced in MR?
Displaced
When do you use the bell in the cardiac exam?
-Listening to the mitral valve for MS
What does malar flush indicate?
MS (pulmonary hypertension with low cardiac output)
A palpable 2nd heart sound in the pulmonary area indicates what condition?
Pulmonary hypertension
By what 3 features should severity of aortic stenosis be assessed?
- Character of arterial pulse
- Signs of heart failure
- Presence or absence of 2nd heart sound
What manoeuvre should be attempted in suspected HCM? What will the finding be?
Valsalva
Murmur gets quieter if patient crouches down due to increased afterload and consequent splinting open of the outflow tract
Give 3 echocardiographic features of severe AS?
- Area <1cm2
- Mean valve gradient >40mmHg
- Aortic jet velocity >4m/s
Intervention for aortic stenosis may be indicated if mean gradient >40mmHg and any of which other 3 features are present?
- EF <45%
- Abnormal response to exercise
- VT
- LVH >15mm
- Valve area <0.6cm2
Name 4 common complications of AS
- Endocarditis
- Heart failure
- AV block
- Embolic events
How to differentiate AS from sclerosis?
- Normal 2nd HS
- Normal pulse character
- Frequently seen in the elderly
Name 3 conditions associated with AS
- Angiodysplasia of the colon and anaemia
- Other valvular disease (especially mitral)
- Coarctation of the aorta
What are the indications for surgery in aortic stenosis?
-Symptomatic (especially syncope)
