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46 Cards in this Set
- Front
- Back
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AV valves |
tricuspid- Right mitral - Left |
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Semilunar valves |
Pulmonic - right Aortic - left |
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What happens in S1(systole) |
Semilunar valves ope aortic pulmonic AV valves close tricuspid (right) mitral (left) |
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What happens in S2 |
Diastole AV valves close mitral (left) tricuspid (right) semilunar valves open aortic (left) pulmonic (right) |
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Systole |
between S1 and S2 |
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Diastole |
between S2 and S1 |
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S3 |
fluid overload pregnancy chf Kentucky (S3=Y) |
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S4 |
S4 Stiff ventricular wall Mi LV hypertrophy chronic HTN Tennessee (S4=ne) |
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IV/VI murmur |
thrill I/VI - very soft VI/VI - very loud, across the room |
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Murmur location: Left 5th ICS, MCL |
Mitral Middle of the chest also known as the apex or base |
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2nd Right ICS |
AORTIC |
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2nd Left ICS |
Pulmonic |
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Systolic murmurs |
Mitral Regurg Aortic +MVP (mitral valve prolapse) |
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Diastolic murmurs |
Mitral |
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Systolic heart failure |
inability of the heart to contract decreased cardiac output |
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diastolic heart failure |
inability of the heart to relax decreased cardiac output |
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Acute HF |
Left heart lungs S3 (fluid overload Abrupt onset often after acute MI or valve rupture |
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Chronic HF |
Right failure most common cause of R failure = Left failure a result of inadequate compensatory mechanisms over time |
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NYHA class I |
no limitations, no ss |
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NYHA class II |
symptomatic, but only slight with physical activity |
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NYHA Class III |
symptomatic - Marked with physical activity comfortable at rest |
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NYHA Class IV |
Symptomatic at rest severe symptoms |
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SS acute failure (left) |
lungs dyspnea at rest rales wheezing S3 gallop (fluid overload) murmur: mitral regurg (lt 5th ICS, MCL - systolic) |
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SS chronic failure (right) |
swollen feet JVD Hepatomegaly dependent edema (increased cap hydrostatic pressure) PND displaced PMI fatigue S3 +/- S4 |
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CXR findings CHF |
pulm edema kerley B lines effusions |
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pharm management of CHF |
ACE Diuretics (thiazide, loop) Anticoag for A fib |
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non pharm mgmt CHF |
Na+ restriction rest/activity balance wt reduction |
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HTN secondary |
5% all cases Causes: estrogen use renal disease pregnancy endocrine Renal artery stenosis |
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HTN exacerbating factors |
smoking obesity ETOH NSAIDs |
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Severe HTN headache |
suboccipital pulsating morning resolves throughout the day |
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Heart sound with HTN |
S4 (stiff heart) |
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threshold for => 60 |
150/90 |
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Threshold for <60 |
140/90 |
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Threshold for all adults (regardless of age) with: CKD, DM |
140/90 |
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Non-AA HTN treatment |
Thiazide CCB ACE/ARB |
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AA HTN treatment |
Thiazide CCB |
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CKD HTN treatment |
ACE/ARB |
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reassess HTN Tx after how long |
1 month increase dose or add med reassess monthly until at goal |
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When do you refer to HTN specialist? |
if 3 or more drugs are needed |
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HTN thraputic lifestyle changes(TLCs) |
restrict dietary sodium wt loss DASH diet Exercise: 40 min/day most days |
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DASH diet |
rich in: fruits veg low fat dairy reduced saturated fat total fat |
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Hypertensive urgency |
180/110 without progressive target organ dysfunction |
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HTN urgency SS |
May or may not be associated with: severe HA SOB epistaxis severe anxiety |
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HTN urgency mgmt |
oral therapies: lonidine captopril nifedipine |
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HTN emergency |
180/130 or lowerwith evidence of impending or progressive target organ dysfunction |
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progressive target organ dysfunction |
fudoscopic changes: flame-shaped retinal hemorrhages soft exudates papilledema (swelling of disc) hypertensive encephalopathy intracranial hemorrhage unstable angina acute MI acute LV failure with pulm edema disecting AAA eclampsia |
