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10 Cards in this Set

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Systemic conditions that increase transvalvular flow (ie. benign ejection or diastolic murmur) include:
fever, anemia, thyrotoxicosis, and pregnancy
Causes of Pansystolic murmur:
tricuspid/mitral regurge, VSD

mitral: heard best at apex- has uniform intensity through out systole. S1-S2. radiates to the axilla

the smaller the VSD the louder, also may have a thrill
Late systolic murmur, continues to A2, think....
often regurgitant mitral due to prolapse... note mid systolic click.
DDx for diastolic murmurs...
early decrescendo due to incompetent A or P; mid/late "rumbling" murmurs turbulent flow past T or M
continuous murmur
patent ductus arteriosus
EKG abnormalities with transmural infarct.
ST segment elevation, T wave inversion, and Q waves in injured region.
EKG abnormalities with epicardial infarct.
ST segment depression, and T wave inversion in injured region.
Condidtions confused with acute MI.
Aortic dissection, pericariditis (diffuse ST elevation), pulmonary embolism, esophogeal spasm/reflux, pneumothorax
Serum BioMarkers in MI, temporal sequences:
Myoglobin - CK-MB - Troponins
Myo- 2-4 hrs, rapidly cleared in Kidney, not specific, non Dxstic
CK-MB- rise 3-12 hours following, delyed 24hr peak; N after 48, Use reletive index vs total.
Troponins- GOLD STD, absent in health pts. Must get sample to Lab STAT, TnT in heart vs TnI in skeletal muscle (i think).
Define Cardiac Shock
Severely decreased cardiac output and hypotension (systolic <90); greator than 40% of ventricular mass is infacted. Mortality 70%