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10 Cards in this Set

  • Front
  • Back
enlargement of what chamber causes esophageal pain?
left atrium
associations:
opening snap
systolic click
ejection click
MS, MVP, AS
what does ST depression on a stress test mean?
cardiac ischemia (CAD)
what determines the flow through a VSD?
the size of the hole
the resistance downstream
what extra heart sound to VSD pts have and why?
they have S3 gallop
volume overload
what causes eisenmenger's syndrome?
Eisenmenger's VSD

over time, increased flow and pressure to lungs damages the intima, lung arteries are gradually destroyed, gets worse and worse

FINALLY, the pulmonary vascular resistance gets so high that there is a Right to Left shunt. Less and less flow to lungs -> hypoxia, death.

eisenmenger's syndrome patients dont ever get sick enough to fail to thrive

they are older when it is finally picked up, and it is too late to fix!
only rx is heart and lung transplant
what symptoms does a child with VSD present with and why?
VSD, L to R shunt, esp as lung resistance decreases (remember mechanical, biochemical, and remodeling) too much flow to lungs, pulm edema, cant breathe well, tachypnic, cant eat well b/c they're tachypnic, failure to thrive at 4-6 wks
what kind of murmur do you hear in ASD patients?
a systolic murmur (pulmonary valve) from too much flow - Right Heart volume overload.

also you hear fixed splitting of A2 and P2 because P2 takes longer but it is no longer as dependent on VR. increasing VR doesnt increase SV because it is already getting so much LtoR shunt
why doesnt flow thru ASD make a murmur?
not enough P gradient across atria!
in which defect is compliance so impt?
ASD.

compliance of RA increases shunt! (as you become an adult, RA gets bigger and more compliant)