PACES Revision Course Flashcards
What are important points of any cardio px you have to say?
On general insp: well + not tachypnoeic
O/e of hands: nad, pulse, BP
O/e of H+N: no pallor, carotid artery character, JVP
On insp of chest: no scars
On palpation: apex beat not displaced + no heave or thrills
On auscultation: HS 1+2 audible w no added sounds
Lung bases, peripheral oedema, obs chart
JVP
Check all the way up to the ear lobes, biphasic, impalpable
Systolic Murmurs
Aortic Stenosis
Mitral Regurg
Tricuspid Regurg
Aortic Stenosis
Loudest in the aortic area
Radiates to the neck
A/w narrow pulse pressure, slow rising carotid pulse, thrill in the aortic area
Mitral Regurg
Quiet S1, pansystolic murmur loudest in the apex best heard on inspiration, S3
Radiates to the axilla
A/w displaced apex beat and apical thrill
What does mitral valve prolapse sound like?
MR but w a mid-systolic click
Tricuspid Regurg
Loudest in the tricuspid area
Best heard on INSpiration
A/w elevated JVP, left parasternal heave, palpable liver
Diastolic Murmurs
Aortic Regurg
Mitral Stenosis
Tricuspid Stenosis
Aortic Regurg
Early diastolic murmur loudest at the left lower sternal edge when sitting forward
Best heard held in EXpiration
A/w eponymous signs, collapsing pulse, dynamic apex
Mitral Stenosis
Loud S1 and audible S2 followed by an opening snap and MDM
A/w AF, malar flush, tapping non-displaced apex beat, left parasternal heave
What causes a loud S2?
HTN + Pulm HTN (will also have a left parasternal heave)
What is a left parasternal heave a sign of?
Right ventricular hypertrophy
What are S3 and S4 due to?
S3: rapid ventricular filling
S4: atrial contraction against stiff ventricles
What are the stages of clubbing?
1: inc fluctuancy of bed
2: loss of angle b/w nail and bed
3: inc curvature of nail
4: expansion of terminal phalanx
