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17 Cards in this Set

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  • Back
What is the percussion wave?
It's the tap that you feel on a pulse
Occurs near the peak of flow velocity and a late tidal wave
What is the tidal wave?
Felt as a prolongation of the tap, occurring at the peak of aortic pressure
What causes a slow rising pulse?
Fixed LV outflow obstruction (aortic stenosis)
What causes a rapidly rising pulse?
LV volume overload (mitral regurg, VSD, increase in rate of pressure)
Elevated EDV
LVH
What causes a small amplitude?
Small effective SV
CHF
Shock
Restrictive cardiomyopathy
Constrictive pericarditis
Tamponade
What causes a large amplitude?
Large SV
Decreased PR
Lack of elasticity of great arteries
Aortic insufficiency
Fever
Hyerthyroidism
Pregnancy
What is pulsus alternans?
Seen in severe CHF
LV --> alternation of LV systolic P and stroke volume
What is pulsus paradoxus?
Regular pulse with gradual and cyclic variation in in amplitude of pulse, relatd to respiration
Fall > 10mmHg or when pulse completely disappears during inspiration
What pathological conditions --> pulsus paradoxus?
Cardiac tamponade
Constrictive pericardiits
SVC obstruction
Anything w wide variation of intrapleural pressure
What is bisferiens pulse?
Sharp upstroke followed by collapse and then a second systolic wave
"Spike and dome" configuration
When is bisferiens pulse seen?
Significant aortic insufficiency
Aortic stenosis
IHSS
What is anacrotic pulse?
Being able to palpate the anacrotic notch
What causes anacrotic pulse?
Severe aortic stenosis
What is a dicrotic pulse?
Accentuation of dicrotic wave
What causes dicrotic pulse?
Good resilience of arterial wall
Decreased SV
Fast HR
Low or high SVR
Fever
What can cause late P2?
RBBB
PVC (L)
Pulmonary HTN
RV failure
ASD
Dilation
VSD
Pulmonary stenosis
What causes reveresed splitting with late A2?
LBBB
PVC (R)
Systolic HTN
LBBB
Ischemic heart disease
PDA
Aortic regurg
Aortic stenosis
Ischemic heart disease
Severe aortic dilation