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30 Cards in this Set
- Front
- Back
- 3rd side (hint)
Causes of chest pain
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1. Angina pectoris
2. Pericarditis 3. Shingles: 4. Gastro esophageal reflux 5. Dissecting aortic aneurysm: 6. Musculoskeletal pain 7. Pleuritic pain |
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Types of angina pectoris
Typical (stable) |
Etiology/Pathogenesis: Most common form. Critical stenosis [reduction of coronary artery to fixed stenosis]
Presentation: Crushing or squeezing substernal pain that may radiate down left arm. Associated w/ increased demand- physical activity, emotional excitement Relieving factors: Rest & Vasodilators |
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Types of Angina pectoris
Prinzmetal (variant) |
Etiology/ Pathogenesis: Cause & mechanism not clear [may be due to coronary artery spasm]
Presentation: Occurs @ rest & awakens patient from sleep [not associated w/ physical activity] Associated w/ ST segment elevation & indicative of transmural ischemia Relieving factor: Vasolidators |
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Types of Angina pectoris
Unstable (crescendo) |
Etiology/ Pathogenesis: Disruption of plaque w/ superimposed thrombosis & vasospasm [not complete occlusion YET]
Presentation: Harbinger of subsequent MI Pre-infraction angina Pain that occurs w/ progressively increasing frequency & is precipitated with progressively less effort. Often occurs at rest, & tends to be more prolonged in duration. Often accompanied by nausea & diaphoresis. Relieving factors: Vasodilators but NOT rest |
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Pericarditis
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Soreness behind the sternum, Aggravated w/ deep inspiration & movement
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Dissecting aortic aneurysm
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Severe persistent pain w/ tearing sensation between scapula
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Musculoskeletal pain
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Pain from chest wall
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Pleuritic pain
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Pain from parietal pleural layers
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Anxiety disorders
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Dyspnea not related to exertion, sighing excessively
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Palpitation: Abnormal awareness of heart beat & can be caused by ...
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Thyrotoxosis [hyperthyroidism], Caffeine products, Sympthmimetic drugs, Cardiac arrythmias [MVP, Extrasystoles, PSVT]
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Syncope: Sudden loss of consciousness due to reduced blood supply to the brain can caused by...
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cardiac arrhythmias, vasovagal response, postural hypotension, mictruation syncope, vertebro-basilar synocope
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Signs of Aortic regurgitation
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(1) Capillary pulsations in the nail bed [Quincke’s pulse]
(2) Femoral bruit [pistol shot] --> Durozier’s sign (3) Head nodding with the pulses --> de Musset’s sign (4) Mid diastolic murmur (5) Austin Flint murmur |
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Signs of Atrial septal defect
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(1) Wide, fixed splitting
(2) Pulmonary flow murmur (3) EKG may show Right Bundle Branch Block [RBBB] |
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Signs of Ventricular septal defect
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(1) Loud pansystolic murmur --> Maladie de Roger
(2) Forceful apex beat with a thrill (3) Mitral diastolic flow murmur |
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Signs of Eisenmenger’s syndrome
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(1) Clubbing
(2) Central cyanosis (3) EKG will reveal right ventricular hypertrophy |
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Signs of Hypertrophic cardiomyopathy [HCOM]
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(1) Angina on exertion
(2) Dyspnea on effort (3) Syncope (4) Sudden death in young adults |
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Cardiac cycles
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i) S1: Closing of mitral & tricuspid valves [AV valves]
ii) S2: Closing of aortic & pulmonic valves iii) S3: Rapid ventricular filling |
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Large v wave JVP
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Tricuspid regurgitation
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Giant/cannon a waves JVP
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Hepatojugular reflux, Complete heart block
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Absent a waves JVP
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Atrial fibrillation
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Use ball of your hand to feel for thrills: Palpable murmurs
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turbulence of blood flow
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Heart sounds
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1/ S1: Closing of mitral & tricuspid valves [AV valves]
2/ S2: Closing of aortic & pulmonic valves 3/ S3: Rapid ventricular filling [low pitch]--> Mitral [5] 4/ S4: Atrial contraction [low pitch]-->Between [4] & [5] |
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Cause and position of murmurs
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Due to: turbulence of blood flow
Position (1) Between S1-S2: Systolic & high pitched (2) Between S2-S1: Diastolic & low pitched & soft Lateral decubitis position for MS [left-sided S3 & S4 diastolic murmur]: mitral area [5] (question image) Position for AR [diastolic decrescendo murmur]: erb [3] (answer image) |
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Peripheral signs of CVS dysfunction
Clubbing Cardiac causes |
endocarditis, Cyanotic congenital heart diseases
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Peripheral signs of CVS dysfunction
Clubbing Pulmonary causes |
Lung cancer, Empyma, Cystic fibrosis, Fibrosing alveolitis
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Peripheral signs of CVS dysfunction
Clubbing GI causes |
Inflammatory bowel diseases [Chron’s disease, Ulcerative colitis], Cirrhosis
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Signs of infective endocarditis
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Splinter hemorrhages
Janeway lesions Osler’s nodes Roth's spots Conjuctival/Scleric hemorrhages |
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Splinter hemorrhages: signs of infective endocarditis
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Signs of infective endocarditis: Janeway lesions
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Painless erythmatous hemorrhagic macular or nodular lesions on the palms of hands
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Signs of infective endocarditis: Janeway lesions
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Painless erythmatous hemorrhagic macular or nodular lesions on the palms of hands
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