20 Clinical Applications of Cardiovascular Physiology Flashcards
Aortic stenosis: What does it sound like, when does it occur?
- Lub-Swish-Dub
- After S1 (ejection murmur lasts thru rest of systole)
Mitral regurgitation: What does it sound like, when does it occur?
- Swiiiiiiiiisshhhhhhh-dub
- Holosystolic (onset ventricular contraction, obscures S1)
Aortic regurgitation: What does it sound like, when does it occur?
- Lub-Swiiiiiiiiissshhh (decrescendo)
- Starts with S2 (onset ventricular relaxation) lasts thru part of diastole
Mitral stenosis: What does it sound like, when does it occur?
-Starts after S2 with “opening snap” then low-pitch “rumbling” diastolic murmur
3rd heart sound: What does it sound like, how does it work?
- “Kentucky” (Lub-Dub-Swish)
- Tensing of chordae tendinae and AV ring during early ventricular filling
- Normally heard in healthy young. Heard worse in heart failure.
- Blood slaps into ventricular wall
4th heart sound: What does it sound like, how does it work?
- “Tennessee,” a gallop. (Lub-Dub-Swish but longer dist. between Dub and Swish than in a 3rd heart sound)
- Sudden rise in ventricular pressure caused by atrial contraction (caused by high atrial pressure, or low ventricular compliance)
- At least lets you know your atria are contracting :)
When estimating jugular venous pressure, the reference point is where, and how many cm are added to the measurement?
- Sternal angle
- 5 cm (because it is always 5 cm above the right atrium)
What is the simplest way to measure left atrium preload?
-Swan-Ganz catheter with capillary wedge pressure
What is the simplest way to measure right atrium preload?
-Jugular venous pressure
How do we calculate cardiac output?
..Beats per min * stroke volume
..Q=V/(C(out) - C(in))
..Amt indicator injected * 60 / (Mean indicator concentration * Curve duration)
