Quick Ref. Pathology Flashcards
Pancystolic (holosystolic) murmur best heard at the apex, often radiates to the left axilla.
Mitral regurgitation
Crescendo/decrescendo systolic murmur heard best in the 2nd-3rd RIGHT interspace close to the sternum.
Aortic stenosis
Most common heart murmur. Late systolic murmur usually preceded by a mid-systolic click.
Mitral valve prolapse
Early diastolic decrescendo murmur heard best along the left side of the sternum.
Pulmonic regurgitation
Late diastolic decrescendo murmur heard best along the lower left side of the sternum.
Tricuspid stenosis
Chromosome 22q11 deletion can cause what (2)?
Truncus arteriosus and Tetralogy of Fallot
Congenital rubella can cause (2)?
PDA or Pulmonary Artery Stenosis
Bicuspid aortic valve results from?
What heart murmur is associated with this?
Turner’s syndrome - in addition to coarctation of the aorta
Aortic regurgitation
Aortic insufficiency can arise from what syndrome?
Marfan
Rumbling late diastolic murmur with an opening snap? How is it heard best?? Head best along the apex of heart (4th stethoscope heart space)
Mitral stenosis
Heard better when Px is in left lateral decubitus position
Foco mitral
High-pitched diastolic murmur associated with a widened pulse pressure?
Aortic regurgitation
Crescendo/decrescendo systolic murmur heard best in the 2nd-3rd LEFT interspace close to the sternum.
Pulmonic stenosis
Continuous machine like murmur occurring both in systole and diastole?
Patent ductus arteriosus (PDA)
Focal myocardial inflammation with multinucleate giant cells. Type of granuloma. Due to what infection?
Aschoff Bodies (rheumatic fever/ heart disease)
What murmur is being described: Holosystolic, loudest at apex, heard best at left lateral decubitus, and enhanced by squatting and expiration.
Mitral Regurgitation
What murmur is being described: Diastolic, heard best along the left sternal border, and is associated with widening of pulse pressure.
Aortic regurgitation
What are the symptoms of left sided heart failure??
Pulmonary symptoms:
- Dyspnea on exertion
- Orthonea
- Paroxomal nocturnal dyspnea
- Pulmonary edema and maybe rales on exam
CF: painful raised lesions on finger pads, fever, AKA-Osler nodes, is indicative of what?
Infective Endocarditis
What are the most common causes for DIC?
Stop making thrombi!! Sepsis Trauma Obstetrics Pancreatitis Malignant neoplasm Transfusions
What is the MOST common coronary artery involved in thrombosis?
Left anterior descending
What is the MC congenital heart anomaly?
Ventral septal defect (VSD)
What heart sound is associated with dilated congestive heart failure?
Dilated congestive heart failure:
-S3 heart sound
What heart sound is associated with chronic hypertension and stiffened L ventricle?
S4 heart sound
When would you have wide splitting?
Pulmonic stenosis
Right bundle branch block
What heart murmur is louder with Valsalva maneuver? Why?
Makes the murmur of hypertrophic cardiomyopathy louder because it increases intrathoracic pressure and thus reduces preload and afterload.
Usually, all other murmurs become quieter
A 3 day old patient presents with a Holosystolic murmur loudest at the tricuspid region of the chest that gets louder with inspiration. What is the likely pathology?
VSD
A 46 yo patient presents with a Holosystolic murmur loudest at the tricuspid region of the chest that gets louder with inspiration. What is the likely pathology? What is the likely cause??
Mitral regurgitation due to IV drug use that may cause endocarditis
Pansystolic (holosystolic) murmur best heard along the left lower sternal border and generally radiates to the right lower sternal border. What murmur is this?
tricuspid regurgitation
Or
Ventricular septal defect
56 YO hospitalized patient presents with acute onset of dyspnea, tachycardia, and confusion. What should your DX be until you can rule out/discard otherwise?
Pulmonary Embolism
20 yo patient presents with rapid onset of sharp chest pain in association with dyspnea. What is the likely diagnosis?
Spontaneous pneumothorax
Patient presents with ST segment elevation only during brief episodes of chest pain. What is the likely diagnosis?
Prinzmetal’s Angina
Patient presents with sharp pain lasting hours to days and is somewhat relieved by sitting forward. What is the likely diagnosis?
Pericarditis
What are the symptoms seen in patients with right sided heart failure?
Right sided heart failure usually shows signs in the body, vs Left sided heart failure usually is seen with pulmonary symptoms.
Peripheral edema
-pedal edema
-pre-sacral edema
Jugular Venous Distention
Hepatic congestion
What is Beck’s Triad? What is it’s association?
Hypotension
Distended neck veins
Distant heart sounds
Associated with cardiac tamponade
Patient presents with the following symptoms:
Hypotension
Increased venous pressure, JVD
Distant heart sounds
Increased heart rate
Pulsus Paradoxus (exaggerated decrease in the amplitude of the systolic BP during inspiration).
What is the most likely diagnosis?
Cardiac tamponade
What is being described:
JVD during inspiration
Decreased capacity of RV
Associated with constructive pericarditis»_space; tamponade
Kussmaul’s Sign
What is being described:
Decreased SBP by more than 10mmHg during inspiration
Decreased capacity of LV
Associated with tamponade»_space; constructive pericarditis
Pulsus paradoxus
What are the diagnostic criteria for rheumatic fever?
J - joint pain <3- pancarditis N- nodules (skin, subcutaneous) E- erythema marginatum S - syndenham chorea
