- StudyBlue
- Nevada
- Touro University (NV)
- Physician Assistant
- Physician Assistant Cardio
- Guadagnoli
- Valvular Heart Disease
Valvular Heart Disease
Physician Assistant Cardio with Guadagnoli at Touro University (NV)
About this deck
By: Matt Padgett
Created: 2011-11-30
Size: 78 flashcards
Views: 24
Created: 2011-11-30
Size: 78 flashcards
Views: 24
About StudyBlue
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At what lipid level is there a risk of pancreatitis?
500
When do the heart valves make audible noise?
When they close
What is the S1 heart sound?
The closure of the AV (mitral and tricuspid) during ventricular contraction (systole).
What does the S1 sound correspond to?
The carotid pulse, closing of mitral and tricuspid valve, and the "lubb" sound.
Which heart sound is the "lubb"?
S1: AV valves closing.
Which heart sound is the "dubb"?
S2: semilunar valves closing.
What are the semilunar valves?
Pulmonic and aortic valves.
What is the S2 heart sound?
The sound of the aortic and pulmonic valves closing during ventricular repolarization (diastole).
What causes a physiologic split in S2?
During respiration, the increased volume of the right ventricle prolongs right ventricular systole. Should disappear on exhale.
What is a fixed S2 split?
A delayed heart sound due to an atrial septal defect.
What could worsen an S2 split?
Pulmonary hypertension, left bundle branch block, or an ectopic beat from right ventricle.
What is the S3 heart sound?
An extra heart sound or gallop rhythm heard in early diastole prior to atrial contraction.
Who commonly have S3 heart sounds?
Pregnant women and children
Who should worry about an S3 heart sound?
Patients over 40.
What does S3 indicate (pathologically)?
Left ventricular dysfunction or left/right ventricular overload.
What disease is S3 a common sign for?
Congestive heart failure (CHF)
What is an S4 heart sound?
Caused by atrial contraction in late diastole and indicates decreased ventricular compliance.
Where is S4 common?
In patients with cardiomyopathy and hypertensive concentric hypertrophy.
What is the right AV valve called?
Tricuspid
What is the left AV valve called?
Bicuspid or Mitral
What are the chordae tendinae?
The chords that anchor the cusps of the AV valves to the papillary muscles.
What occurs during diastole?
Ventricle is relaxed and AV valves are opened so ventricles can fill. Atrial contraction.
What occurs during systole?
Atria fill, the ventricles contract.
When do the semilunar valves open?
At the peak of ventricular contraction.
What is the function of the cusps on the semilunar valves?
At the end of systole when the aorta/pulmonary artery contract due to the increased volume and force blood backward, the flow fills the cusps closing the valves.
What is a mnemonic for remembering how to auscultate for the heart valves?
All Prostitutes Take Money
(The writer of these slides does not endorse testing the validity of the mnemonic)
(The writer of these slides does not endorse testing the validity of the mnemonic)
Where is the best place to hear sounds (murmurs) for the pulmonic valve?
Left 2nd/3rd intercostal space
Where is the best place to listen for mitral sounds?
Near cardiac apex.
Where is the best place to listen for aortic valve sounds?
Right 2nd intercostal space.
Where is the best place to listen for tricuspid sounds?
Lower left sternal border.
How are heart murmurs differentiated from normal sounds?
By their longer duration.
What is the most common cause of a heart murmur?
Heart valve defects.
What is regurgitation (in the heart)?
Blood leaking backward through the heart valve when the valve should be closed.
When do most valve murmurs increase?
Increased blood flow intensity such as squatting or laying down.
When do most valve murmurs decrease in intensity?
Decrease blood flow such as standing or during a valsalva.
When are right sided murmurs loudest?
Inspiration
When are left sided murmurs loudest?
Expiration
What two heart murmurs increase in intensity during standing and valsalva?
Mitral valve prolapse (MVP) and Hypertrophic cardiomyopathy (HCM).
When do MVP and HCM decrease?
When squatting and laying down.
What is the key diagnostic tool for heart murmurs?
2-D ECHO.
How are heart murmurs graded?
On a scale of 1-6 in accordance with intensity.
What is a grade 1 heart murmur?
Very faint and may not be heard in all positions.
What is a grade 2 heart murmur?
Quiet but distinguished immediately.
What is a grade 3 heart murmur?
Moderately loud
What is a grade 4 heart murmur?
Loud with a palpable thrill.
What is a grade 5 heart murmur?
Loud with a thrill, so that you can take the stethoscope partly off the chest and still hear it.
What is a grade 6 heart murmur?
Have you ever seen Alien?
So loud that you can hear it with the stethoscope off the chest.
So loud that you can hear it with the stethoscope off the chest.
When do systolic murmurs occur?
During ventricular contraction.
What are the two possible causes of systolic murmurs?
The AV valve being open when it shouldn't be or the semilunar valves being closed (stenosis) when they shouldn't be.
What is a mitral regurgitation?
Described as a blowing murmur, it's heard throughout systole (S1).
What is a complication of mitral regurgitation?
Left atrial hypertrophy -> A-fib -> clot formation -> stroke
What's the general rule with heart murmurs and x-rays?
By the time you see something... it's too late, damage done.
What is aortic stenosis?
A harsh crescendo-decrscendo ejection murmur due to narrowing or aorta.
What are the signs/symptoms of mitral regurgitation?
Dyspnea/orthopnea, fatigue, palpitations.
What are the signs/symptoms of aortic stenosis?
Syncope, cyanosis, fatigue, weakness.
Where can an aortic murmur radiate to?
Right clavicle
What is a tricuspid regurgitation?
A blowing murmur that is heard throughout systole commonly caused but the dilation of the right ventricle.
What is tricuspid regurgitation commonly associated with?
Pulmonary hypertension and jugular vein distension.
What is pulmonary stenosis?
A harsh murmur increasing the split of S2.
What is the most common cause of pulmonary stenosis?
It's usually congenital.
What are the common signs/symptoms of pulmonary stenosis?
syncope, angina, dyspnea
What is a mitral valve prolapse?
A click murmur during systole (S1) that increases during standing and valsalva but decreases during squatting and laying down.
What is the most often cause of mitral valve prolapse?
Myxomatous degeneration (whatever that is)
When is MVP more common?
In patients with Grave's disease, Von Willebrand's syndrome, sickle cell, and rheumatic heart disease.
What is hypertrophic cardiomyopathy?
A harsh crescendo-decrescendo murmur heard during S1 that increases with standing and valsalva but decreases with squatting and laying down.
Where is hypertrophic cardiomyopathy heard best?
Left sternal border.
What is mitral stenosis?
Heard after S2 but before a loud S1, have an opening snap that is low pitched (rumble).
When does mitral stenosis increase?
With exercise
When does mitral stenosis decrease?
With valsalva maneuver.
What is aortic regurgitation?
A blowing/decrescendo murmur after S1.
What are the signs/symptoms of aortic regurgitation?
Prominent carotid pulses, pulsing cap refill, head bobbing, heart failure, cardiogenic shock.
What is tricuspid stenosis?
A loud S1 with pre-systolic crescendo and mid-diastolic thrill.
What is pulmonary regurgitation?
A mid-diastolic decrescendo blowing murmur.
What are rheumatic murmurs?
Cause by acute inflammation due to group A strep and autoimmune reaction damaging heart tissue.
What is the Jones criteria?
Diagnosis for rheumatic murmurs. Requires 2 major or 1 major and 2 minor.
What are the major Jones criteria?
1. Myocarditis
2. migratory asymmetric polyarthritis
3. chorea (spastic movements)
4. subcutaneous nodules
5. erythema marginatum.
2. migratory asymmetric polyarthritis
3. chorea (spastic movements)
4. subcutaneous nodules
5. erythema marginatum.
What are the minor Jones criteria?
1. arthralgia
2. fever
3. increased sedrate
4. increased ASO titer
5. Hx rheumatic fever
2. fever
3. increased sedrate
4. increased ASO titer
5. Hx rheumatic fever
What is the most common heart valve damaged?
Mitral
About this deck
By: Matt Padgett
Created: 2011-11-30
Size: 78 flashcards
Views: 24
Created: 2011-11-30
Size: 78 flashcards
Views: 24
About StudyBlue
STUDYBLUE makes things that make you better at school.
Things like online flashcards with photos and audio.
Things like personalized quizzes and friendly reminders about when (and what) to study next.
Think of it as a digital backpack™: access to all of your study materials online and on your phone.
STUDYBLUE exists to make studying efficient and effective for every student, for free. Join us.
“Simply amazing. The flash cards are smooth, there are many different types of studying tools, and there is a great search engine. I praise you on the awesomeness.”
Dennis
Dennis