Cardio: Ventricular Hypertrophy

Front 1

What kind of hypertrophy creates parallel cardiac remodeling? Series?

Back 1

Pressure overload (systolic) causes parallel remodeling (increase in myocyte width.)
Volume overload (diastolic) causes series remodling (increase in myocyte length.)

Front 2

How do you assess the apical impulse on physical exam?

Back 2

Assess location,
estimate size (diameter,)
assess amplitude (normal, hyperdynamic, small, absent,)
assess contour (duration...normal, sustained, palpable A-wave.)

Front 3

What are the clinical manifestations of hyperdynamic states?

Back 3

Hyperdynamic states cause an increase of force and amplitude of the apical impulse; location and contour are unchanged.

Front 4

What are the clinical manifestations of volume overload?

Back 4

Volume overload causes an increase in amplitude without a change in contour; downward and leftward displacement.

Front 5

What are the clinical manifestations of pressure overload?

Back 5

Pressure overload causes the apical impulse to be prolonged in duration reflecting increased left ventricular ejection time, sustained heave or thrust, not displaced. Palpable a-wave.

Front 6

What are some problems with diagnosing cardiomegaly with an X-ray?

Back 6

A large looking heart can sometimes mean fluid around the heart, not cardiomegaly.
Also, you can't tell how thick the wall is.

Front 7

What does aortic stenosis look like on an EKG?

Back 7

Aortic stenosis is pressure overload. Exaggerated QRS amplitude, downsloping ST, inverted T waves.

Front 8

What does aortic regurgitation look like on an EKG?

Back 8

Aortic regurgitation is volume overload. Exaggerated QRS in lateral leads like V6 because of large heart.