cardiac cycle and heart sounds Flashcards
(17 cards)
s1
“lub”
closure of AV valve
s2
“dub”
closure of semilunar valve
s3
filling of ventricles (AV valves open)
normal in children
can be pathological in adults
“kentuckee”
s4
atrial filling/ contraction of atria
“tenness-ee”
auscultation locations (APTM)
- Aortic R 2nd ICS
- Pulmonic L 2nd ICS
- Tricuspid L 4th ICS
- Mitral L 5th ICS mid clavicular line
exceptions to preload rule
1) HOCM
2) MVP
HOCM (hypertrophic obstructive cardiomyopathy)
- increase in preload improves aortic murmur by pushing the septum away from aortic outflow track
- decrease in preload causes worsening
MVP (mitral valve prolapse)
-increase in preload improves mid systolic click by allowing leaflets to return to normal orientation
preload
volume of blood sent to heart
afterload
pressure ventricles have to generate to move blood forward in arterial system
AORTIC STENOSIS
– Crescendo-Decrescendo murmur – Most likely case presentation • Old-SAD (syncope, angina, dyspnoea) • Calcified aortic valve • Radiates UP to the carotids
mitral regurgitation
– “Rheu-mitral”
– Radiates to the axilla
– Best heard at apex
– Holosystolic murmur (steady)
tricuspid regurgitation
– Holosystolic
– History of IVDA
“want to TRI some drugs”
aortic regurgitation
– Early blowing diastolic murmur – Presentations • Connective tissue disorders • Marfan’s Syndrome • “Head-bobbing” • Water-Hammer pulse • Femoral Bruits “AR, thar she BLOWS!!!”`
mitral stenosis
Opening “Snap”
– “RHEUmitral
• History of
Rheumatic fever
– “The OS is MS”
“The Operating System is MicroSoft
HOCM
• Family history of sudden cardiac death at a young age
• Utilize specific maneuvers to identify it
– Louder with Decreased preload
– Louder with Decreased afterload
mitral valve prolapse
– Midsystolic “click”
– Clinical presentation of a young woman with a psychiatric history
– Myxomatous Valvular disease in the stem question
– “See the MVP to be the MVP and everything will click”
