Key Associations part 2

Question 1

S3 heart sound

Answer 1

High ventricular filling pressure (eg, mitral regurgitation, HF), common in dilated ventricles

Question 2

S4 heart sound

Answer 2

Stiff/hypertrophic ventricle (aortic stenosis, restrictive cardiomyopathy)

Question 3

Constrictive pericarditis

Answer 3

TB (developing world); idiopathic, viral illness (developed world)

Question 4

Holosystolic murmur

Answer 4

VSD, tricuspid regurgitation, mitral regurgitation

Question 5

Ejection click

Answer 5

Aortic stenosis

Question 6

Mitral valve stenosis

Answer 6

Rheumatic heart disease

Question 7

Opening snap

Answer 7

Mitral stenosis

Question 8

Heart murmur, congenital

Answer 8

Mitral valve prolapse

Question 9

Chronic arrhythmia

Answer 9

Atrial fibrillation (associated with high risk of emboli)

Question 10

Cyanosis (early; less common)

Answer 10

Tetralogy of Fallot, transposition of great vessels, truncus
arteriosus, total anomalous pulmonary venous return,
tricuspid atresia

Question 11

Late cyanotic shunt (uncorrected left to right becomes right to left)

Answer 11

Eisenmenger syndrome (caused by ASD, VSD, PDA;
results in pulmonary hypertension/polycythemia)

Question 12

Congenital cardiac anomaly

Answer 12

VSD

Question 13

Hypertension, 2°

Answer 13

Renal artery stenosis, chronic kidney disease (eg, polycystic kidney disease, diabetic nephropathy), hyperaldosteronism

Question 14

Aortic aneurysm, thoracic

Answer 14

Marfan syndrome (idiopathic cystic medial degeneration)

Question 15

Aortic aneurysm, abdominal

Answer 15

Atherosclerosis, smoking is major risk factor

Question 16

Aortic aneurysm, ascending or arch

Answer 16

3° syphilis (syphilitic aortitis), vasa vasorum destruction

Question 17

Sites of atherosclerosis

Answer 17

Abdominal aorta > coronary artery > popliteal artery > carotid artery

Question 18

Aortic dissection

Answer 18

Hypertension

Question 19

Right heart failure due to a pulmonary cause

Answer 19

Cor pulmonale

Question 20

Heart valve in bacterial endocarditis

Answer 20

Mitral > aortic (rheumatic fever), tricuspid (IV drug abuse)

Question 21

Endocarditis presentation associated with bacterium

Answer 21

S aureus (acute, IVDA, tricuspid valve)
Strep viridans (subacute, dental procedure), 
S bovis (colon cancer) 
Culture negative (Coxiella, Bartonella, HACEK)

Question 22

Temporal arteritis

Answer 22

Risk of ipsilateral blindness due to occlusion of

ophthalmic artery; polymyalgia rheumatica

Question 23

Recurrent inflammation/thrombosis of small/medium

vessels in extremities

Answer 23

Buerger disease (strongly associated with tobacco)

Question 24

Cardiac 1° tumor (kids)

Answer 24

Rhabdomyoma, often seen in tuberous sclerosis

Question 25

Cardiac tumor (adults)

Answer 25

Metastasis, myxoma (90% in left atrium; “ball valve”)