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24 Cards in this Set
- Front
- Back
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Describe the 5 finger method
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For cardiovascular exam
1. History (most important for chief complaint and family history) 2. physical- Jugular venous pressure 3. ECG 4. X-ray 5. Lab- BNT, CMP, cardiac enzymes |
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Know proper sequence in physical assessment of cardiac function
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inspection, palpation, percussion,
auscultation, and positioning of patient |
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What do you need to know about Chest pain?
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location, duration, type, onset, severity, radiate (neck and jaw?), previous experience, makes it worse/better, associated symptoms, patients take
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What type of history usually relates to heart conditions?
What are the main etiologies (causes)? |
very vague- more importantly find out why...
- etiologies- 1. HTN, ischemic, valvular, pericardial, infections, congenital 2. Anatomic abnormalities 3. physiologic disturbance |
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What are the classes assigned to fatigue, palpations, dyspnea, angina according to NYHA?
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1. no limitations of physical activities
2. slight limitations of physical activity ordinary activity causes symptoms 3. marked limitation of physical activity and less than ordinary activity causes symptoms 4. inability to carry out any physical activity |
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According to the american cardiac association... the 4 stages in development of HF syndrome.
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A. CAD, HT, DM; who do not demonstrate impaired LV function, hypertrophy or enlargement of chambers
B. Asymptomatic patient; has LVH and/or impaired LV function C. Patient with current or past symptoms of HF with structural heart disease D. Refractory HF; eligible for specialized treatment (mechanical support, transplants) |
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What is normal JVP?
What most often causes elevated JVP? How is it measured? |
0-9 estimate of central venous pressure
- elevated RV diastolic pressure - height of JVD, come across horizontally and vertically to sternal notch... add this to distance from R ventricle to sternal notch and add together |
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What are important jugular venous pressure waves?
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A- right atrial contraction associated with S1. precedes carotid pulsation
C- less clinical revelance- backward push by closure of TV during isovolumetric systole X- passive atrial filling and atrial relaxation V- atrial filling- Y slope/descent- open TV and rapid RV filling |
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When a giant A wave is seen what might this indicate as underlying pathology?
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Giant a wave seen in
1. Obstruction between RA and RV (i.e.T.S., Right atrial myxoma) 2. Increased pressure in RV (i.e. P.S.) 3. Pulmonary hypertension 4. Recurrent pulmonary emboli 5. A-V dissociation (complete heart block, V.T.) (cannon ‘a’ waves). RA contracts against the closed TV. |
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Describe the 5 finger method
|
For cardiovascular exam
1. History (most important for chief complaint and family history) 2. physical- Jugular venous pressure 3. ECG 4. X-ray 5. Lab- BNT, CMP, cardiac enzymes |
|
|
Know proper sequence in physical assessment of cardiac function
|
inspection, palpation, percussion,
auscultation, and positioning of patient |
|
|
What do you need to know about Chest pain?
|
location, duration, type, onset, severity, radiate (neck and jaw?), previous experience, makes it worse/better, associated symptoms, patients take
|
|
|
What type of history usually relates to heart conditions?
What are the main etiologies (causes)? |
very vague- more importantly find out why...
- etiologies- 1. HTN, ischemic, valvular, pericardial, infections, congenital 2. Anatomic abnormalities 3. physiologic disturbance |
|
|
What are the classes assigned to fatigue, palpations, dyspnea, angina according to NYHA?
|
1. no limitations of physical activities
2. slight limitations of physical activity ordinary activity causes symptoms 3. marked limitation of physical activity and less than ordinary activity causes symptoms 4. inability to carry out any physical activity |
|
|
According to the american cardiac association... the 4 stages in development of HF syndrome.
|
A. CAD, HT, DM; who do not demonstrate impaired LV function, hypertrophy or enlargement of chambers
B. Asymptomatic patient; has LVH and/or impaired LV function C. Patient with current or past symptoms of HF with structural heart disease D. Refractory HF; eligible for specialized treatment (mechanical support, transplants) |
|
|
What is normal JVP?
What most often causes elevated JVP? How is it measured? |
0-9 estimate of central venous pressure
- elevated RV diastolic pressure - height of JVD, come across horizontally and vertically to sternal notch... add this to distance from R ventricle to sternal notch and add together |
|
|
What are important jugular venous pressure waves?
|
A- right atrial contraction associated with S1. precedes carotid pulsation
C- less clinical revelance- backward push by closure of TV during isovolumetric systole X- passive atrial filling and atrial relaxation V- atrial filling- Y slope/descent- open TV and rapid RV filling |
|
|
When a giant A wave is seen what might this indicate as underlying pathology?
|
Giant a wave seen in
1. Obstruction between RA and RV (i.e.T.S., Right atrial myxoma) 2. Increased pressure in RV (i.e. P.S.) 3. Pulmonary hypertension 4. Recurrent pulmonary emboli 5. A-V dissociation (complete heart block, V.T.) (cannon ‘a’ waves). RA contracts against the closed TV. |
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What are problems associated with X-wave, Vwave, Y-slope
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X- steep descent seen indicates cardiac tamponade or constrictive endocarditis
V wave- prominent V wave in TR (tricuspid regurgitation and pulmonary HTN) Y descent- deep descent in severe TR, slow Y descent suggests obstruction to RV filling |
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What is Kussmauls sign and what pathology does it indicate?
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when venous column rises during inspiration rather than falls
- could be R heart failure, constrictive pericarditis, or RV infarction |
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What is the 6 point grading system for heart murmurs?
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1. Barely audible
2. Soft, but easily heard 3. loud, without a thrill 4. loud with a thrill 5. loud with minimal contact between stethoscope and chest - thrill 6. loud, can be heard without a stethoscope- thrill |
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What are the normal values for the following...
a. Right atrial pressure (RAP) b. Right ventricle (RV) c. Pulmonary artery pressure (PAP) |
a. 0-8 mmHg
b. 25/6 mmHg c. Syst 15-30, Diast 5-12, Mean 10-20 mmHg |
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What are the normal values for the following...
a. PCWP (pul capillary wedge pressure) b. CO c. CI= CO/BSA |
a. 8-15
b. 3.5-7 l/m c. 2.5-4 l/min2 |
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What are the normal values for the following...
a. systemic vascular resistance (SVR) b. pulonary vascular resistance (PVR) |
a. 900-1500 dynes/second/cm
b. 155-255 dynes/second/cm |
