Peds Cardiology Flashcards
(18 cards)
Systolic murmur source
AS, PS, MR, TR
Diastolic murmur source
MS, TS, AR, PR
source of fixed s2 split
Aortic septal defect
physiologic s2 split is when?
inspiration
pathologic s2 split is when?
expiration
key factors in determining source of murmur
timing, systolic or diastolic?, location
aortic stenosis sound and cause
click
old age, congenital, rheumatic fever
bicuspid (instead of tri, inflammation and calcification)
pulsus parvis et tardis (feel radial pulse while auscultating, will be weak and late relative to strong sounding lub - heart working hard to overcome stenosis)
pulmonic stenosis cause
tetrarology of fallot
what causes right sided valve disease
pulmonic and tricuspid
IV drug abuse
rheumatic fever (autoantibodies after group b strep)
effect of rheumatic fever on the heart
any valve, stenosis or regurg
Mitral>Aortic>Tricuspid
regurg sound
holosystolic
stenosis sound
click
mitral regurg, location, what makes it worse
radiate to axilla
increased afterload makes it worse,
HTN, coarctation of the aorta
maneuvers - hand grip or squatting
tricuspid regurg, location, what makes it worse
radiate to RSB (heard on LSB the loudest)
increased with inc right heart flow
INSPIRATION (inc interthoracic heart flow)
aortic regurg
diastolic murmur
widened pulse pressure
blowing murmur
mitral stenosis
diastolic, opening snap then rumble
may be caused by rheumatic heart disease(immigrant?, no vaccinations?)
manuevers (2 types)
changes afterload - systemic, sustained squatting and hand grip, less left murmur
changes preload- inspiration, inc preload to rt heart and enhances rt heart murmurs and laying supine, end diastolic volume. expiration decreases preload, enhance left sided murmur
valsalva maneuver
decrease right sided heart return, will hear decrease in right sided murmur
also parasypmpathetic tone dec, dec. pulse and blood pressure
