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39 Cards in this Set
- Front
- Back
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tamponade |
compression of the heart by an accumulation of fluid in the pericardial sac. |
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Common chief complaints |
chest pain, palpitations, syncope, edema, fatigue, dyspnea, cough |
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Common associated symptoms |
diaphoresis SOB N/V palpitations skipped beats |
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Palpitations |
subjective |
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Syncope |
fainting brief LOC r/t low cerebral perfusion, preceded by lightheadedness (averted by lying down or head btwn knees) -listen to heart and feel pulse to check perfusion |
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Heart attack signs |
chest discomfort pain, pressure, squeezing, fullness
upper body discomfort arm, jaw, back, abdomen SOB Other symptoms cold sweat, N, light-headedness Women subtle, nonspecific signs: nervousness, weakness or fatigue, sleep disturbance |
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non-modifiable cardiovascular risk factors |
age >55 men >65 women gender males at younger age family history of premature CVD Race higher for black's |
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modifiable cardiovascular risk factors |
hypertension hypercholesterolemia elevated LDL or low HDL obesity BMI >30 kg/m3 physical inactivity tobacco usage particularly cigarettes DMII |
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Chronic Heart Disease equivilants |
Clinical CHD symptomatic carotid artery disease peripheral artery disease abdominal aortic anurysm diabetes |
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Major independent CHD risk factors |
Cigarette smoking Hypertension BP >140/90 or on HTN Rx Low HDL cholesterol <40mg/dl Family history of premature CHD Age men >45, women >55 |
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Lifestyle CHD risk factors |
Obesity BMI >30 Atherogenic diet |
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Marfan Syndrome |
a hereditary disorder of connective tissue, resulting in abnormally long and thin digits and also frequently in optical and cardiovascular defects |
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Emerging CHD risk factors |
lipoprotein A Homocysteine prothrombotic factors proinflammatory factors impaired fasting glucose subclinical atherosclerosis Berkley Heart lab test |
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Pack years |
packs/day x years smoked = pack years (i.e. 2 packs/day x 30 years = 60 pack years) |
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metabolic syndrome |
3 or more -large waist circumference men >40" women >35" -elevated TG >150 mg/dl or TX (thromboxane) -Reduced HDL-C <40 men, <50 women or TX -Elevated BP >130/85 or TX Elevated fasting glucose >100 mg/dl or TX |
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Changes associated with aging |
decreased blood vessel elasticity orthostatic hypotension (postural) widening pulse pressure decreased baroreceptor response increased incidence of CV disease |
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JVD |
Jugular Vein Distention |
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Hepatojugular reflux |
push on liver jugular veins will rise for a few seconds elevated CVP (central venous pressure): jugular veins will elevate and remain elevated during pressure |
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Precordium |
the region of thorax immediately in front of the heart |
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Five "listening posts" |
Aortic Pulmonic Erb's Tricuspid Mitral |
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Lift, heave, thrust, thrill |
lift: quick and light
heave: sharp and firm thrust: diffuse and long thrill: palpable vibration |
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S1 heart sound |
loudest at apex of heart coincides with upstroke of carotid artery pulse closure of mitral and tricuspid valves beginning of systole |
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S2 heart sound |
loudest at base reflects closure of aortic and pulmonic valves beginning of diastole Split: A2 closes just before P2 |
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Stethoscope use when listening to the heart |
Use the bell |
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Systole vs Diastole |
systole: between s1 and s2 |
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S3 heart sound |
early diastolic filling dull, soft, low-pitched heard best at apex with bell normal in kids & 3rd trimester =fluid volume overload i.e.CHF |
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S4 heart sound |
atrial contraction late in diastole soft, low-pitched heard best at apex with bell = decreased ventricular compliance i.e. stiff ventricle, HTN, cardiomyopathy |
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Murmurs |
Blowing swishing sound due to turbulent blood flow |
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Valve stenosis |
valve does not open all the way |
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Valve incompetence, regurgitation, or insufficiency |
valve will not close or 'regurgitates' |
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Systolic murmurs |
blood pushing through stenotic Aortic or Pulmonic valves blood pushed up and beyond regurgitant or incompetent Mitral and Tricuspid valves |
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Diastolic murmurs |
blood falling backward through regurgitant pulmonary and aortic valves blood moving down through stenotic mitral and tricuspid valves during normal diastole |
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Grading murmurs |
1-6; softest to loudest |
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Pericardial friction rub |
inflammation of pericardium high-pitched, scratchy, like rubbed sandpaper best heard at apex |
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Pulmonary Embolism |
Occlusion of pulmonary vessels Results in ischemia of blood vessels Assessment; acute dyspnea, increase HR, RR rapid and shallow, confusion, sense of doom, restlessness, agitation, cyanosis -central then peripheral, hemoptysis, pulse ox <80, decreased BP, diaphoretic, crackles, ronchi |
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Congestive Heart Failure |
cough dyspnea and DOE orthopnea crackles (often late in inspiration, begin in lung bases and proceed upward as condition worsens, often bilaterally and do not clear with cough) |
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Aortic Stenosis |
dizziness/fainting fatigue palpitations chest pain DOE and PND Systolic murmur (loud, harsh) JVD Death |
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Mitral Regurgitation |
fatigue palpitations orthopnea PND Murmur (pansystolic, loud, blowing) |
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Myocardial infarction |
chest pain or pressure diaphoresis EKG changes Anxiety Dyspnea |
