Notes in cardio exam pt 2

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Status	Last Update	Fields
Published	09/08/2024	systolic murmurs are:A/P {{c1::STENOSIS}}M/T {{c1::REGURGITATION/INSUFFICIENCY}}{{c2::MVP}} (CLICK, not a murmur){{c2::VSD}} AND {{c2::ASD}}
Published	09/08/2024	diastolic murmurs are:A/P {{c1::REGURGITATION/INSUFFICIENCY}}M/T {{c1::STENOSIS}}{{c2::S3}}/{{c2::S4}}
Published	09/08/2024	a {{c1::stenosis}} is hear when the valve should be open
Published	09/08/2024	a {{c1::regurgitation/insufficiency}} is heard when a valve should be closed
Published	09/08/2024	{{c1::Aortic regurgitation}} is a blowing, diastolic decrescendo murmur heard best at the 2nd - 4th Left ICS, radiating to the apex and right ste…
Published	09/08/2024	{{c1::PDA}} is a continuous machine like murmur with a wide pulse pressure
Published	09/08/2024	{{c1::S3/S4}} are extra heart sounds heard during diastole
Published	09/08/2024	{{c1::a fib}} is an irregularly irregular heart rhythm
Published	09/08/2024	{{c1::mitral stenosis}} is a low pitch, Mid-diastolic murmur heard best at the apex
Published	09/08/2024	{{c1::Aortic Stenosis}} is a mid-systolic murmur heard best at the 2nd right ICS, which radiates to the neck and left sternal border.
Published	09/08/2024	{{c1::Tricuspid regurgitation}} is a pansystolic blowing murmur heard best at the left lower sternal border which radiates to the right sternum a…
Published	09/08/2024	{{c1::Mitral Valve Prolapse}} is a mid-systolic click
Published	09/08/2024	{{c1::Ventricular Septal Defect}} the most common congenital systolic murmur heard best at the left lower sternal border
Published	09/08/2024	{{c1::atrial septal defect}} is a systolic ejection murmur. Congenital. Heard best at the 2nd left ICS with an early to mid-systolic rumble
Published	09/08/2024	{{c1::pulmonic stenosis}} is a systolic crescendo decrescendo murmur heard best at the 2nd- 3rd left ICS, radiating to the left shoulder or neck
Published	09/08/2024	{{c1::Mitral Regurgitation}} is a pan-systolic, blowing murmur heard best at the apex, which radiates to the left axilla
Published	09/08/2024	{{c1::aortic}} area is the 2nd right intercostal space
Published	09/08/2024	{{c1::pulmonic}} area is the 2nd left intercostal space
Published	09/08/2024	{{c1::erb's point}} area is the 3rd left intercostal space (left sternal border)
Published	09/08/2024	{{c1::tricuspid}} area is the 4th left intercostal space (left sternal border)
Published	09/08/2024	{{c1::mitral or apex}} area is the 5th left intercostal space (midclavicular line)
Published	09/08/2024	Normally, {{c1::left}} sided cardiac pressures are greater than {{c1::right}} sided pressures.{{c1::L}}V pumps against the higher pressure systemic va…
Published	09/08/2024	The {{c1::heart rate}} affects auscultation: auditory recognition of S1 occurs because it follows the pause in diastole. As the {{c1::HR}} increases, …
Published	09/08/2024	S1 occurs simultaneously with {{c1::carotid pulsation}} and {{c1::apical impulse (PMI)}}
Published	09/08/2024	Ventricular pressure {{c1::falls}}, causing aortic then pulmonic valve closure, generating second heart sound (S2), ventricular relaxation, onset…
Published	09/08/2024	Ventricular pressure {{c1::rises}}, forcing mitral then tricuspid valve closure generating first heart sound (S1); ventricles contract, ejecting …
Published	09/08/2024	S{{c1::2}} is heard best at the Base: R 2nd ICS MCL
Published	09/08/2024	S{{c1::1}} is heard best at the apex: L 5th ICS MCL
Published	09/08/2024	a split S2 is considered a normal finding when heard during {{c1::inspiration}} only. if there is no variation with respirations it is always patholog…
Published	09/08/2024	a {{c1::split s2}} is heard at the left 2nd ICS and with the diaphragm
Published	09/08/2024	an {{c1::S3}} occurs due to rapid ventricular filling colliding with residual blood left in a dilated (Compliant) LV → systolic HF
Published	09/08/2024	an S3 may be normal in peds, athletes, or pregnancy. otherwise think {{c1::HF}} symptomatic adults
Published	09/08/2024	an {{c1::S3}} sounds like a gallop
Published	09/08/2024	an {{c1::S3}} is best heard at the Apex (L 5th ICS MCL) in LLD position with a bell (low-pitched)
Published	09/08/2024	an {{c1::S4}} is best heard at the Apex (L 5th ICS MCL) in LLD position with a Bell (low-pitched)
Published	09/08/2024	S4 would never be heard in {{c1::a-fib}}
Published	09/08/2024	{{c2::Standing}} = {{c1::Strain}} phase of valsalva
Published	09/08/2024	{{c2::Squatting}} = {{c1::Release}} phase of valsalva
Published	09/08/2024	{{c2::standing}} causes:{{c1::↓}} LV volume as a result of {{c1::↓}} venous return to heart{{c1::↓}} preload
Published	09/08/2024	{{c2::squatting}} causes:{{c1::↑}} LV volume from {{c1::↑}} venous return to heart {{c1::↑}} preload
Published	09/08/2024	{{c2::standing}} will {{c1::↑}} MVP because the Click moves earlier in systole and murmur lengthens
Published	09/08/2024	{{c2::squatting}} will {{c1::↓}} MVPDelay of click and murmur shortensCords are kept tight by the increased stretch and can’t snap as loud
Published	09/08/2024	{{c2::standing}} will {{c1::↓}} BV ejected into aorta and {{c1::↓}} Intensity of murmur of aortic stenosis
Published	09/08/2024	{{c2::squatting}} will {{c1::↑ }} BV ejected into aorta and {{c1::↑ }} Intensity of murmur of aortic stenosis
Published	09/08/2024	{{c2::standing}} will {{c1::↑}} Outflow obstruction and {{c1::↑}} Murmur intensity of HOCM
Published	09/08/2024	{{c2::squatting}} will {{c1::↓ }} Outflow obstruction and {{c1::↓ }} Murmur intensity of HOCMIncreased amount of blood k…
Published	09/08/2024	{{c1::Physiologic Ejection}} Murmur occurs due to predisposing conditions altering blood flow (increased volume +/- turbulence d/t elevated HR) w…
Published	09/08/2024	a physiologic ejection murmur is {{c1::systolic}}
Published	09/08/2024	Mitral Valve Prolapse (MVP) without Associated: is heard just a mid systolic click; leaflet folding in and being abruptly stopped by {{…
Published	09/08/2024	{{c1::Mitral Valve Prolapse (MVP) without Associated}} is heard best at  Left lower sternal border  (L 5th ICS MS, apex)…
Published	09/08/2024	{{c1::MVP}}: abnormal {{c2::ballooning}} of mitral valve into left atrium due to leaflet {{c3::elongation}} & {{c4::redun…
Published	09/08/2024	{{c1::Diastolic}} murmurs are ALWAYS pathologic!
Published	09/08/2024	{{c1::MVP with Mitral Regurgitation}} : Blood leaks through a regurgitant mitral valve throughout the entirety of ventricular systole (holos…
Published	09/08/2024	MVP with Mitral Regurgitation: {{c1::duration}} of MR murmur correlates with severity of valvular leakage (NOT intensity of murmur)
Published	09/08/2024	{{c1::Degenerative}} MR caused by MVP or flail leaflet (post MI complication)
Published	09/08/2024	{{c1::Functional}} MR caused by LV dilation (pulls on leaflets, pts w/ hx of cardiomyopathy)
Published	09/08/2024	{{c1::MVP with Mitral Regurgitation}}: Mid systolic click + mitral regurgitation (Holosystolic, high-pitched, blowing murmur heard best at the ap…
Published	09/08/2024	{{c1::MVP with Mitral Regurgitation}}: heard best at Apex (L 5th ICS MCL)Diaphragm Can radiate to left axilla
Published	09/08/2024	Symptoms of {{c1::MVP with MR:}}SOB / DOE (d/t pulm edema)A fib (dilated LA)*HF / declining EF (systolic HF)JVD, PND
Published	09/08/2024	{{c1::MVP with MR}} and {{c1::MS}} can cause a-fib
Published	09/08/2024	Severe MR is a {{c1::LV}} volume problem (blood keeps being regurgitated back into LA so the LV has to deal with the same blood multiple tim…
Published	09/08/2024	{{c1::Aortic Stenosis}}: Harsh, often loud crescendo-decrescendo mid-systolic ejection murmur
Published	09/08/2024	Associated PE findings of {{c1::AS}}:-Delayed carotid pulse: Pulsus parvus (weak) et tardus (late)-Hyperdynamic, displaced apical impulse (latera…
Published	09/08/2024	Pathophysiology OF {{c1::AS}}:↑ gradient between {{c2::LV}} and aorta is a {{c2::LV}} afterload problem (LV has to work too hard a…
Published	09/08/2024	with {{c1::AS}}-S4 is often present d/t LVH-S2 may be decreased or even absent
Published	09/08/2024	Etiologies of {{c1::AS}}:Senile calcific (elderly) → TAVR (uses calcification to hold new valve in place)Bicuspid (younger pts)Rheumatic (rare in US)
Published	09/08/2024	Symptoms OF {{c1::AS}}: progressiveChest Pain / anginaSyncopeHeart Failure
Published	09/08/2024	{{c1::Mitral Stenosis}}Typically will present with evidence of right heart failure Irregular rhythm of atrial fibrillation (dilated LA)
Published	09/08/2024	{{c1::Mitral Stenosis}}Pathophysiology:↑ left atrial-ventricular gradient → ↑ LA pressures results in *pulmonary edema and exertional dyspnea
Published	09/08/2024	Symptoms: {{c1::mitral stenosis}}Right HFLA dilationPulmonary HTNA fib (pulmonary vein problems)SOB
Published	09/08/2024	Pathophysiology:{{c1::Aortic regurgitation}} is a LV volume problemThe LV dilates then eventually results in HF
Published	09/08/2024	Symptoms {{c1::aortic regurgitation}}:DOB / DOEHFChest pain
Published	09/08/2024	signs of worsening symptoms of {{c1::aortic stenosis}}symptoms, dilating LV
Published	09/08/2024	{{c1::Aortic regurgitation}}: Backflow of blood into the left ventricle from the aorta due to an insufficient closure of the aortic valve during …
Published	09/08/2024	Chronic AR = {{c1::widened pulse pressure}}
Published	09/08/2024	Etiology of {{c1::AR}}:Degenerative AV diseaseBicuspid aortic valve (normal = 3 valves)Rheumatic diseaseAortic valve endocarditis (IV drug users
Published	09/08/2024	{{c1::Aortic Regurgitation}}High-pitched blowing decrescendo diastolic murmur
Published	09/08/2024	{{c1::aortic regurgitation}} Heard best with patient sitting up, leaning forward, and holding breath in end expiration
Published	09/08/2024	{{c1::Tricuspid Regurgitation}}Etiology:Chronic HF (volume overload)Severe COPD (causes pHTN)Pulmonary HTNRV failure is both a cause & effect of s…
Published	09/08/2024	athophysiology:Severe {{c1::TR}} is a {{c2::RV}} volume problem is typically secondary to RV dilation from pulm HTNTypically …
Published	09/08/2024	Symptoms {{c1::tricuspid regurgitation}}R sided HF (backs up into body) JVD + prominent V waves in jugular veinsLower extremity edemaAscites / ab…
Status	Last Update	Fields