Cardio in class

Question 1

PS results in

normal PA pressure

AS radiates to the

MR radiates to the

Answer 1

RVH and high pressure

25-30

carotid arteries/LLSB

Left axilla/back

Question 2

Cx associated with aortic stenosis

inc risk for

surgery indicated when

normal appearing aortic valve should look like

Hypertrophic obstructive cardiomyopathy occurs due to

Answer 2

Bicuspid aortic valve

dissection/IE

sx occur (syncope, angina, HF)

3 leaflets, mercedes benz sign

inc myocardial thickness below the aortic valve

Question 3

LA enlarged, presents with

Sx of IE

Cavitary lung lesions indicate

murmur is usually

Typical bacterial cause

Sx less common in TCV endocarditis (more common in L sided dz)

Which side dz is more common?

Answer 3

double density

Fever, splinter hemorrhage

thromboemboli from tricuspid vegetation

holosystolic, louder during inspiration

Staph aureus

Splinter hemorrhages, Osler/Janeway nodes

Left

Question 4

Left sided HF signs

Dilated cardiomyopathy due to MI occurs with

Over time

Classic ausculatory findings of left sided systolic heart failure include

S4 indicates decreased

Answer 4

Orthopnea, laterally displaced PMI, crackles/edema

LV muscle loss/remodeling (systolic dysfxn)

heart dilates, HF occurs

left sided S3 at apex (MR)

ventricular compliance

Question 5

MS has a ___ S1

usually caused by

AR peripheral pulses

JVP greater than 4cm is

A wave indicates

X descent indicates

V wave indicates

Y descent indicates

Answer 5

loud (stenotic valve pops with closure due to high pressure)

rheumatic fever

bounding- large stroke volume, low diastolic pressure

abnormal, elevated

atrial contraction (end diastole)

ventricular systole & atrial relaxation w pulling down of Atrium/TCV

atrial filling peaks w opening of TCV at onset of diastole

ventricular filling

Question 6

Cx that produce LV dilation

RV impulse can be inc w

Angina type pain

result of

related to

mimic by

relieved by

Answer 6

ischemic cardiomyopathy, MR/AR

RV dilation/PHTN

dull, diffuse, left sided, pressure

coronary artery narrowing w inadequate perfusion for muscle need

exertion

esophageal spasm/pressure overload

rest/nitrates

Question 7

Anginal type chest pain also occurs w

these lead to

Pericarditis pain relieved by

MR caused by

murmur is

severe may have ___ S2

Answer 7

AS, HTN, PHTN

subendocardial ischemia from pressure overload

sitting forward

leaflet abnormality, chordae rupture, papillary muscle infarct, valve ring widening

holosystolic

widened (early AV closure)

Question 8

PHTN sx

large artery filling defect suggest, treat w

severe PHTN, ____ contraindicated

Coronary artery occlusion tx options

Answer 8

SOB, loud S2, inc JVD, clear lungs

embolus, anticoagulant/RH cath

stress test

stress test, LH cath, aspirin/clopidogrel

Question 9

S4 reflects

not produced with

requires a

JVD inc caused by

typically a result of

Answer 9

atrial contraction

w/out organized atrial activity (so not A fib)

stiff ventricle

inc systemic venous blood volume/pressure

Biventricular/isolated RH failrue

Question 10

Other causes of JVD

Volume overload

Pericardial dz

Dz assc w PHTN

Answer 10

Renal failure, CHF

Constrictive pericarditis, tamponade

COPD, fibrosis, PE, PHTN

Question 11

Isolated LH failure (MI, MR/AR) do not lead to

MVP with normal LV fxn has ______ pressures

Tamponade findings

Pulsus paradoxus

Normal SBP during inspiration

Answer 11

inc JVD if acute

normal filling pressures

hypotension, inc JVP, dec heart tones, clear lungs, enlarged heart (imaging)

drop in SBP by >10 during inspiration

drops slightly due to IV septum compressing the Left heart

Question 12

DDx for pericardial effusion

AS murmur

etiologies

may have

severe can cause

Answer 12

malignancy, uremia, iatrogenic, infection, post MI (Dressler/ventricular rupture), CVD, dissection

crescendo-decrescendo, systolic

bicuspid valve, RF, calcific degeneration

dec and small carotid upstroke, narrow S2 split, dec A2, S4

syncope, angina like pain

Question 13

S2 splitting increases with

Normal

Patho

LBBB will delay

BAV and Marfan produce

Large LA will inc

Answer 13

Inspiration

PS, ASD, MR, RBBB

A2

aortic root dilation, require replacement

the carinal angle >65

Question 14

S3 usually due to

AS produces, leads to

MVP prolapse murmur

Answer 14

MR or AR (huge left ventricle due to volume overload)

LVH, S4

midsystolic click+/- mid late systolic murmur

Question 15

Holosystolic murmur in PHTN due to

TR vs MR

anorexigen leads to

RVH can result from, produce

Answer 15

TR

TR has + Carvallo’s sign, max at LLSB, large V jugular pulse

PHTN

PHTN, S4 located at LLSB

Question 16

Constrictive pericarditis signs

classic result from

PHTN leads to _____ S2, ___ shadows

PHTN and tamponade do not produce

MR leads to

Answer 16

RHF, clear lungs, pericardial calcifications, Kussmaul’s sign

Tb

loud S2, PA shadows

kussmaul’s sign

LHF (rales) and cardiogenic edema