Cardiac Flashcards
(57 cards)
S1, which valves
“Motivated”. Mitral and tricuspid valves (leading to ventricles/AV) close. Systole. Usually benign.
S2
“Apples”. Aortic and pulmonic valves (s = semilunar valves, ie the ones leading to vessels). Diastolic. Usually bad murmurs.
S3
“Kentucky”. Can be normal in athletes, children, pregnant women. Abnormal over age 40 (CHF, heart failure)
S4, where heard, what else is it called
“Tennessee”. Caused by stiffness of L ventricle; therefore can be normal aging in some elderly. “Atrial gallop or kick”. Best heard at APEX.
S2 Split, where is it heard
Heard over pulmonic area. Normal if heard on inspiration and gone on expiration.
Where is pulmonic area
Second ICS, upper left of sternum
MR. ASS
Mitral regurgitation and aortic stenosis = systolic
MS. ARD
Mitral stenosis and aortic regurgitation = diastolic
Where is mitral area
AKA Apex, apical pulse. 5th left ICS, slightly medial to midclavicular (think nipple)
Where is aortic area
Right side of sternum, second ICS
Where is Erbs point
3-4 ICS on left sternal border
Describe mitral regurgitation murmur sound, where to hear
Loud, blowing, high-pitched. Listen at apex, can also radiate to axilla.
Describe aortic stenosis murmur sound, where to hear
Second ICS, right of sternum. Harsh, noisy. “Midsystolic”. Sound may radiate to neck.
Describe mitral stenosis, where to hear, what does it sound like
Low pitched, rumbling; “opening snap”. Best heard at apex.
Describe aortic regurgitation, where to hear
High pitched. If due to bad valve, will hear over 3rd ICS by L sternal border. If due to bad aortic root, hear at RUSB
When to use bell of stethoscope
Low pitches
When to use diaphragm of stethoscope
High pitches
What grade of murmur to first palpate thrill
3
Digoxin therapeutic range
0.5-2.0
Digoxin tox symptoms
Vision color change, hyperkalemia, dysrhythmias, confusion
Afib warfarin INR
2-3
Mechanical heart valve INR
2.5-3.5
ACEI suffix
-pril
ARB suffix
-sartan
