Cardio Murmurs et EKGs Flashcards Preview

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Flashcards in Cardio Murmurs et EKGs Deck (57)
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1

S1 heart sound

mitral and tricuspid valves close

2

S2 heart sound

aortic and pulmonary valves close

3

S3 heart sound causes?

early diastolic, occurs with increased filling pressures

cause: CHF, MR, pregnancy, children, dilated cardiomyopathy

4

S4 heart sound causes?

late diastolic, occurs with elevated atrial pressures

cause: ventricular hypertrophy

5

physiologic splitting of heart sounds

occurs during inspiration

6

when does fixed splitting of heart sounds occur?

ASD

7

paradoxical splitting of heart sounds causes?

LBBB, AS

8

wide splitting of heart sounds

RBBB, pulmonic stenosis

9

sound of patent ductus arteriosus? causes?

continuous machine-like murmur

congenital heart disease, congenital rubella

10

sound of ventricular septal defect?

holosystolic, harsh murmur at left sternal border

11

sound of mitral stenosis? causes?

sound: opening click w/ delayed diastolic rumbling (interval btwn S2 and click is inversely correlated w/ severity)

cause: rheumatic fever

12

sound of mitral valve prolapse? causes?

sound: mid systolic click followed by systolic crescendo murmur

cause: myxomatous dgeneration,  rheumatic fever (almost always), or chordae rupture

13

sound of mitral regurgitation? causes?

sound: holosystolic at apex with radiation to axilla (best heard in L decubitus position)

cause: MVP, LV dilation, ischemic heart disease, or rupture of chordae tendinae

14

sound of tricuspid regurgitation? causes?

holosytolic, radiates to R sternal border

cause: rheumatic fever, infective endocarditis, or things that cause RV dilation

15

sound of aortic stenosis? physical findings? causes?

sound: crescendo-descendo systolic ejection murmur (ejection click may be heard); loudest at 2nd right intercostal space (base) with radiation to carotids

parvus et tardus - pulses are weak w/ a delayed peak

cause: aortic sclerosis (age-related), bicuspid aortic valve

16

sound of aortic regurgitation? physical findings? causes?

sound: diastolic decrescendo murmur

PE: bounding pulses and head bobbing

causes: bicuspid aortic valve, aortic root dilation, endocarditis, rheumatic fever, SLE, syphilis

17

purpose of hand grip?

increase TPR (more remains in LV)

18

purpose of valsalva and standing?

decrease VR (less blood in heart's circuit)

19

purpose of inspiration vs expiration?

Inspiration - increase VR (more enters RA/RV)

Expiration - increase flow to LA from pulmonary circuit

20

purpose of rapid squatting vs prolonged squatting?

rapid: increase VR, increase preload

prolonged: increase afterload

21

what increases intensity of AS? decreases?

increase: rapid squatting

decrease: hand grip, valsalva

22

what increases intensity of MR? decreases?

increases: anything that increases TPR: hand grip, squatting

decreases: valsalva

23

what increases intensity of MS? decreases?

increase: expiration (increase LA return from pulmonic circulation)

decrease: valsalva

24

what increases intensity of VSD

increase: hand grip (to increase afterload)

decrease: valsalva

25

what increases intensity of AR? decreases?

increase: hand grip 

decrease: vasodilators, valsalva

26

what increases intensity of MVP? decrease?

increase: handgrip, squatting (increase TPR; later onset of click/murmur)

decrease: valsalva, standing (decrease VR; earlier onset of click/murmur)

27

what increases the intensity of R heart sounds?

inspiration

28

what increases intensity of tricuspid regurgitation? decreases?

increase: inspiration (maneuvers that increase RA return)

decrease: valsalva

29

type of arrhythmia?

at risk for?

trmt?

a-fib

  • Irregularly irregular
  • Ø P waves in between irregularly spaced QRS complexes

At risk of: Atrial stasis, thromboembolic stroke

Trmt:

  • Rate control
  • Anti-coagulation
  • Pharmacological or electrical cardioversion

30

type of arrhythmia?

trmt?

a-flutter

Rapid succession of identical back-to-back atrial depolarization waves

Trmt:

  • Class IA, IC, or III (slows down atrial contraction so that the waves can collide and cancel out, and the SA node can take over)
  • ß blockers or Ca channel blockres
  • catheter ablation