Walden Flashcards
(audible between 1st and 2nd heart sound)
Systolic murmurs
(high pitch), heard at mitral area- radiates to left axilla
MR/mitral regurg
(medium pitch) heard at AORTA area- radiates to neck
AS/aortic stenosis
(midsystolic click) heard at mitral area
MVP/mitral valve prolapse
ABNORMAL ASSOC WITH AORTIC/PULMONIC VALVES (audible between 2nd and 1st heart sound)
Diastolic murmurs
(high pitch) heard at AORTA area
AR/aortic regurg
(low pitch with bell) heard at mitral area
MS/mitral stenosis
closure of atrioventricular valves , state of systole
S1
closure of semilunar valves
S2
heard in pulmonic, sign of CHF, S3 gallop heard in pregnancy and thyrotoxicosis/ know other presentations of HF
S3
heard in elderly not associated with heart disease, normal
S4
apical/radial pulse taken at same time, find difference
Pulse deficit
causes sudden death in young athletes
Hypertrophic cardiomyopathy
5th ICS midclavicular, apex, apical area, PMI, apical pulse
Mitral area
2nd ICS to the right side of upper border of sternum,
Aorta area
First time audible LOUD WITH PALPABLE THRILL
Grade of murmurs 4
lifestyle modification changes, lose weight, stop smoking, reduce sodium, limit alcohol, adequate electrolytes
HTN- first line therapy
arterioles pressing on veins, arteries are smaller than veins, its hypertensive retinopathy, copper wire arterioles, flamed shaped hemorrhages
HTN- AV nicking
America flag change of colors fingertips toes TX CCB
Raynaud’s phenomenon
narrowing of the large blood vessel that leads from the heart, systolic BP on lower extremities is supposed to be higher compared to upper extremities, in COA its vice/versa (weak radial pulse and bounding femoral pulse) CAUSED BY CONGENITAL HEART DEFECT
Coarctation aorta
Impedance of arterial blood flow in lower extremities ankle brachial index
Peripheral arterial disease
check pedal pulses, ABI test exercise by walking lifestyle modifications -smoking cessation, antiplatelet
Peripheral arterial disease TX
varicose veins result from venous incompetence secondary to valvular dysfunction, low extremity edema, skin discoloration, ulceration, DVT/PE are complications warm to touch
Chronic venous insufficiency
light exercise, stockings, weight loss, elevate legs
Chronic venous insufficiency TX
right side heart fx, causes HF, pulm HTN, tricuspid valve stenosis, superior vena cava obstruction, constrictive pericarditis, hypervolemia, cardiac tamponade
Jugular vein distention
sharp pain, worsens laying down
Pericarditis
infection of the endocardium Fever is the most common symptom of IE TX amoxicillin or macrolide
Bacterial endocarditis
An abnormally large decrease in stroke volume, systolic blood pressure and pulse wave amplitude during inspiration. The normal fall in pressure is less than 10 mmHg. Associated with status asthmatic-us
Pulsus paradoxes or paradoxical pulse
Atrial and diastolic pressures in the ventricle and pericardial pressures as well as exaggerated inspiratory decrease in arterial systolic pressure (pulsus paradoxus) and arterial hypotension
Cardiac tamponade
Most often present at birth but can occur in adults after surgery or a heart attack involves a hole in the wall between the heart’s lower chambers, blue skin from poor circulation. TX Lasix, Lisinopril, percutaneous vsd closure sx, self-heal,
Ventricular septal defect
hyperkalemia, Vision changes (unusual), including blind spots, blurred vision, changes in how colors look, or seeing spots Dx digoxin level, electrolytes
Digoxin toxicity
Chest pain relieved by rest
Angina
Chest pain not relieved by rest squeezing tightness, elephant sitting on my chest, ST Elevation and tomb stone on EKG
MI
First line TX Ace or Arb
CHF
TX first line life modifications, niacin fenofibrate
Cholesterol<200 HDL >40 LDL <100, Triglycerides <150
side effect confusion, rhabdo-lab is CK, no grapefruit, antifungals, abxs,
Statins
Abdominal obesity, HTN, hyperlipidemia, related to diabetes
Metabolic syndrome
Weight/height Greater than 25
BMI
