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Year 2 Cardiovascular > Harvey > Flashcards

Flashcards in Harvey Deck (39):
1

what generates heart sounds?

blood velocity changes / valve closure

2

what are the good and bad causes of a split heart sound?

good - larger volume

bad - slower contraction speed

3

S3 - when, sound, why

when - early-mid diastolic
sound - groaning
why - ventricular wall noise from resistance to filling

4

S4 - when, why

when - late diastolic, end of ventricular filling
why - ventricular wall resistance to atrial kick

5

what are the best ways to hear S3 and S4?

apex with the bell in left lateral recumbent position

6

RA pressure

0 - 5 mm Hg

7

RV pressure

30 / 5

8

pulmonary mean pressure

20

9

the pulmonary wedge pressure is equal to the pressure in what chamber? what is the pcwp?

LA

15

10

LV pressure

120/10

11

what is the order of naming convention for heart murmurs?

grade - cycle - intensity - radiation

12

what are the left sided systolic murmurs?

aortic stenosis
mitral regurgitation
hypertrophic cardiomyopathy

13

what are the right sided systolic murmurs?

pulmonic stenosis
tricuspid regurgitation

14

what are the causes of aortic stenosis?

age, calcification
congenital disease (bicuspid valve)
infective endocarditis

15

is aortic stenosis a left-sided or right-sided murmur? is it systolic or diastolic?

left sided
systolic

16

what is the cause of hypertrophic cardiomyopathy?

left ventricular outflow tract obstruction

17

is aortic regurg a left-sided or right-sided murmur? is it systolic or diastolic?

left sided
diastolic

18

what are the causes of aortic regurg?

endocarditis
root dilation
congenital (bicuspid valve)
CT disorder

19

is mitral stenosis a left-sided or right-sided murmur? is it systolic or diastolic?

left sided
diastolic

20

where does mitral stenosis radiate?

precordial area

21

what are the causes of mitral stenosis?

infectious endocarditis
calcific changes

22

does mitral regurg permit backward flow during systole or diastole?

systole

23

what are the causes of mitral regurg?

MVP from myxomatous degeneration
endocarditis, rheumatic fever
CT disease
MI with papillary rupture
pulmonary HTN

24

when is MV prolapse heard?

late systole

25

what is an austin flint murmur?

severe aortic regurgitation

26

is an austin flint murmur systolic or diastolic? where is it best heard?

mid-diastolic or pre-systolic

apex

27

what does an austin flint murmur sound like?

low pitched rumbling

28

what is the direction of flow in an austin flint murmur?

mixing of antegrade mitral valve blood and regurgitant blood from the aorta

29

what does a pericardial friction rub sound like? how is it heard best?

cabasa

leaning forward and exhaling

30

which condition is heard better upon doing a valsalva maneuver?

HCM

31

what does the hand squeeze do? which murmurs increase when doing a hand squeeze?

increases systolic gradient and intraventricular pressures

AR, MR, TR, VSD

32

what is the effect of hand squeezing on aortic stenosis?

decrease in intensity

33

what is the effect of hand squeezing on HCM?

decrease in intensity

34

the hand grip maneuver will decrease murmur intensity in what conditions?

aortic stenosis
HCM
mitral valve prolapse

35

the hand grip maneuver will increase murmur intensity in what conditions?

aortic regurg
mitral regurg
VSD

36

what is the effect of valsalva on blood return?

reduces return and LV volume

37

what is the effect of valsalva on stenoses?

increase

38

where / how is MR augmentation heard best?

left lateral recumbent

39

where / how is AS augmentation heard best?

reverse semi-fowler's in exhalation (lean forward and exhale)