Valve Physical Exam Flashcards
In normal hemodynamics: ____ sided valves open earlier, ______ sided valves close last.
Right and Right
Persistent S2 spitting occurs in ____&____ .
RBBB and pulmonary HTN
Paradoxical splitting occurs because of electrical and mechanical causes. Name them.
Electrical: LBBB, RV pacing.
Mechanical: Decreased LV systolic function, AS, HOCM.
Fixed splitting occurs in____.
ASD. This is because the increased venous return is balanced by reciprocal decrease flow through the ASD.
The P2 heart sound is considered loud if….
It is as loud or louder as the A2 heart sound, if it is heard at all at the apex.
S3 heart sounds are heard in….
Children, young athletes, pregnancy, and CHF.
S4 heart sounds in which conditions? Absent in which arrhythmia?
Hypertension, hypertrophy, Stiff LV. Cannot hear in a-fib (no atrial contraction).
S3/S4 heart sounds are ____ pitched and can best be heard at the ____.
Low pitched. Best heard at LLSB or apex.
Clicks are characteristically ____ pitched. They are divided in to ___ clicks and _____ clicks
High pitched. Ejection clicks and non-ejection clicks.
Ejection clicks occur in ____ systole with ____.
Early systole with valve opening.
Ejection clicks represent _____ or _____.
Bicuspid aortic or bicuspid pulmonic valves.
Non-ejection clicks occur in ______, and usually represent_____.
Mid to late systole. Mitral valve prolapse. Other causes include ventricular septal aneurysm, atrial septal aneurysm, cardiac tumors, pulmonary HTN, systemic HTN.
The carotid pulsation is bisferians in which 3 conditions?
Aortic regurgitation, aortic stenosis with aortic regurgitation, HOCM
Features of a bisferiens pulse include….
Rapid upstroke, percussion wave then tidal wave, rapid run off.
A bifid pulse has a ___ and ____ appearance and doppler and is seen in what condition?
Spike and dome. Hypertrophic cardiomyopathy.
