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24 Cards in this Set
- Front
- Back
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In what conditions would you hear a systolic ejection murmur?
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valvular aortic stenosis
idiopathic hypertrophic subaortic stenosis pulmonic stenosis ASD |
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When would you hear a flow murmur?
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fever, anemia, exercise, pregnancy, large stroke volume (bradycardia, complete heart block, aortic regurgitation)
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When would you hear a pansystolic murmur?
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mitral regurgitation
tricuspid regurgitation VSD |
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Diastolic murmurs?
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aortic regurgitation (blowing, decrescendo, high-pitched, pandiastolic)
mitral stenosis (opening snap?) |
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When do you hear a wide split of S2?
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ASD, pulmonic stenosis, RBBB, RV overload (pulmonary embolus)
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When do you hear a paradoxical split of S2?
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LBBB
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What is pulsus alternans and when do you hear it?
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variations in blood pressure associated with alternating weak and strong LV contractions; in severe LV dysfunction (CHF)
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What is a positive Kussmaul sign and when do you see it?
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JVP increases with inspiration; CHF
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What are the ST changes in stable angina, Prinzmetal's variant, and MI?
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stable angina - ST depression
Prinzmetal - ST elevation MI - ST elevation & T-wave inversion with Q-wave development - transmural OR ST depression without Q-wave development |
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How long after an MI would the patient experience a rupture?
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1-7 days
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What is Dressler syndrome?
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postinfarction pericarditis.. it's autoimmune and occurs 2-10 wks after MI
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What are the five major criteria for the diagnosis of acute rheumatic fever?
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migratory polyarthritis
Sydenham's chorea erythema marginatum carditis subcutaneous nodules |
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What is marantic endocarditis?
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a paraneoplastic syndrome
sterile vegetations on the mitral valve associated with mucin-producing tumors of the colon and pancreas also associated with DIC |
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Discuss the stages of compensation in shock.
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compensated stage - reflex tachycardia and peripheral vasoconstriction (cold, clammy, pale extremities)
decompensated stage - initial compensation isn't enough CO; decreased BP, increased tachycardia, metabolic acidosis, respiratory distress, decreased renal output irreversible - coma and death |
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Which valve abnormality presents with bounding pulses and a wide pulse pressure?
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aortic regurgitation
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What is Fiedler's myocarditis? Rheinhard's?
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idiopathic myocarditis with eosinophilic infiltrate with giant cell and granuloma formation; rheinhard's - extensive eosinophilic infiltration
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What causes myocardial pseudocysts?
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Chagas' disease* (T. cruzi) and toxoplasmosis
*Romana sign - unilateral swelling of the eyelid |
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Describe dilated cardiomyopathy. What are the clinical features? Complications? Etiologies?
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decreased contractility, stasis, mural thrombi
progressive CHF, thromboembolism, arrhythmia pregnancy-induced nutritional, hypertensive, volume, or metabolic abnormalities; alcohol tox, genetic, postviral infection (*there's a GAPP in my heart so it's DILATED) |
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Describe hypertrophic cardiomyopathy. What are the clinical features? Complications? Etiologies?
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asymmetrical hypertrophy of the ventricular septum, causing obstruction of the LV outflow tract, LV>RV, dilated atria
dyspnea, angina, a-fib, syncope, sudden death, mural thrombi, CHF genetic, catecholamine hypersensitivity, ischemia, primary collagen disorder (my HYPER CAT IS GENETICally COLored) |
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What are the causes of restrictive cardiomyopathy?
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cardiac amyloidosis, sarcoidosis
*rheumatoid arthritis! AA |
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What is the most common location of a myxoma?
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left atrium
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What is the most common primary cardiac tumor in kids and what systemic disease is the tumor associated with?
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rhabdomyoma
tuberous sclerosis |
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What neoplasms are most likely to metastasize to the heart? Which layer of the heart is usually involved?
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bronchogenic carcinoma, lymphoma from regional nodes
pericardium |
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Emboli from venous circulation vs. emboli from arterial circulation.
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venous - involve pulmonary circulation **may involve systemic circulation via a cardiac shunt (ASD)
arterial - 75% from mural thrombi due to MI; usually affect legs, then brain, other viscera, and arms |
