Week 7 Flashcards
S1
ventricular contraction
closure of Tricuspid and Mitral valves
time it with carotid pulse to identify
S2
Closure of Aortic and Pulmonic valves
ventricular filling
S3
ventricular filling may cause this
S4
May be produced by atrial contractions
sinus 6 syndrome
malfunction of the sinus node
may cause arrhythmia
systole
contraction
diastole
relaxation
lipid profile screening
every 5 years starting at age 20
CHADS2 scores
Afib & stroke risk
split S1
Usually normal,
best heard in tricuspid area
split S2
physiologic if it resolves with deep expiration
pediatric chest pain
usually musculoskeletal, pleuritic, GI
thrill
turbulent blood flow
coarction of aorta
pulses stronger in upper extremities than lower extremities
Chest XR
size, shape, congestion
ECG
identify rate, rhythm,
echo
shows congenital defects
Screening for LVH
increases risk for sudden cardiac death
would need echocardiogram for every patient
Hypertension screening
start at age 3
Cyanotic Heart Disease
Pulmonary artery stenosis Pulmonary atresia Tetralogy of fallot Tricuspid atresia truncus arteriosus hypoplastic L heart syndrome transposition of great arteries
Acyanotic heart disease
blood shunts L to R which is less dangerous. Oxygenated blood is coming back over to deoxygenated side patent ductus arteriosus atrial-septal defect Ventricular septal defect Coarction of aorta Aortic stenosis Pulmonary Artery stenosis Patent foramen ovale
Patent ductus arteriosus
in utero, shunts blood away from lungs so ti bypasses lungs
shunts into hole in aorta
Tricuspid atresia
blood cant get through into ventricle, so it goes into L side of heart (where deoxygenated blood is)
Truncus arteriosus
Great vessels don’t develop as they should
hypoplastic L heart syndrome
not compatible with life
L side way smaller than R side
Transpositions of Great Arteries
aorta and pulmonary artery are flip-flopped, leads to cyanosis
coarction of aorta
aorta is tortuous
Ventricular septal defect
hole in septum of ventricles
atrial-septal defect
hole in septum between atrium
left pumps to right- ok since its oxygenated blood going into deoxygenated blood
Patent foramen ovale
opening between septal walls of the 2 chambers of the heart
ok because L side has higher pressure
R to L shunt
dangerous because deoxygenated blood flows into pulmonary system
JVP
reflects right atrial pressure, which in turn equals central venous pressure + R ventricular end diastolic pressure
Syndromes caused by acute myocardial ischemia
Unstable angina, non ST elevation MI, ST elevation MI
Acute Aortic Dissection
anterior chest pain, often tearing or ripping pain into back or neck
Causes of Swelling
R or L ventricular dysfunction, pulmonary htn, obstructive lung disease
anasarca
severe generalized edema extending to sacrum and abdomen
6 Criteria for preventing heart disease
Lean BMI not smoking physically active, healthy diet untreated total cholesterol <200 untreated BP <120/80 fasting BG <100
JVP pulse
best assessed in R internal jugular vein
dominant movement is inward
absent a waves
aFib
increased V waves
tricuspid regurgitation
atrial septal defects
constrictive pericarditis
Causes of decreased carotid pulsations
decreased stroke volume (shock, MI)
local atherosclerotic narrowing
pressure on carotid sinus (bradycardia, drop in BP)
Pulsus Alternans
Pulse is regular
bigeminal pulse that varies beat to beat
paradoxical pulse, varies with respiration
Alternating loud + soft Korotkoff sounds
indicates left ventricular failure
Paradoxical Pulse
a difference between levels of 10 to 12 mmHg
acute asthma, COPD, acute PE, pericardial tamponade
Bruit
Caused by atherosclerotic stenosis, tortuous carotid artery
do not correlate with any clinically significant diseases
High pitched cardiac sounds
S1, S2, murmurs of aortic and mitral regurgitation, pericardial friction rubs
*use diaphragm
Low pitched sounds
S3, S4, mitral valve murmurs
*use bell
Auscultory sounds
S1 louder with rapid heart rates
S2 persistently single
Expiratory splitting
valvular abnormality
P2
suggests pulmonary htn
most common extra heart sound
systolic click of mitral valve prolapse
Diastolic murmurs
reflect regurgitant
Bisferiens Pulse
normal beat alternating with premature contraction
increased arterial pulse with double systolic peak
causes: aortic regurgitation
