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from First Aid

Left Sternal Border Diastolic Murmur: -aortic regurg -pulmonic regurg
Aortic Area Systolic murmur: aortic stenosis, flow murmur
Pulmonic Area Diastolic Murmur: pulmonic stenosis, flow murmur
Tricuspid area Pansystolic murmur (triscuspid regurg, VSD), diastolic murmur (tricuspid stenosis, ASD)
Mitrial area systolic murmur (mitrial regurg), diastolic murmur (mitrial stenosis)
Fick principle CO = (rate of O2 consumption)/(artierial O2 content - venous O2 content)
MAP MAP = 2/3 diastolic + 1/3 systolic
PP PP=systolic - diastolic
R R = P/Q = (8nl)/(pi*r^4)
S3 sound at end of rapid ventricular filling, assoc with dilated CHF
S4 high atrial pressure/stiff ventricle, "atrial kick" assoc with a hypertrophic ventricle
wide splitting of A2 & P2 assoc with pulmonic stenosis
fixed splitting of A2 and P2 assoc with ASD
paradoxical splitting of A2 & P2 assoc with aortic stenosis
U wave caused by hypokalemia
torsades des pointes ventricular tachycardia characterized by shifting sinusoidal waveforms on EKG. can progress to VFib. anything that prolongs the QT interval can predispose to this.
wolff-parkinson-white syndrome accessory conduction pathway from atria to ventricle (budle of kent), bypasses AV node. ventricles begin to partially depol earlier, delta wave on EKG. may result in reentry current leading to supraventricular tach
a-fib chaotic and erratic baseline (irregularly irregular) with no discrete p waves in between irregularly space qrs complexes
atrial flutter rapid succesion of identical, back to back atrial depol waves. sawtooth apearance
1st degree av block PR itnerval prolonged >200ms. asympotomatic
2nd degree mobitz type i (wenchebach) av block progressive lengthening of pr interval until a beat is "dropped" (a p wave not followed by qrs complex). usually asymptomatic
mobitz type 2 av block dropped beats that are not preceded by a change in the length of the pr interval. pathologic condition. often foudn as a 2:1 block (2 p waves to 1 qrs complex). may progress to 3rd degree block
3rd degree av block (complete) atria and ventricles beat independently of each other. both p waves and qrs complexes are present although p waves bear no relationship to qrs complexes. atrial rate is faster than ventricular rate. usually treat with a pacemaker
v-fib completely erratic rhythm with no identifiable waves. fatal arrythmia w/o immediate CPR and defib
aortic arch receptor transmits via vagus n to medulla. responds only to inc bp
cartoid sinus transmits via glossopharyngeal n to medulla. responds to dec and inc in bp
peripheral chemoreceptors carotid and aortic bodies respond to dec PO2 (<60mmHg), inc PCO2 and dec pH of blood
central chemoreceptors respond to changes in pH and PCO2 of brain interstitial fluid, which in turn are influenced by arterial CO2. do not directly respond to PO2. responsible for cushing rxn, response to cerebral ischemia, response to inc intracranial pressurehh
Tetrology of fallot pulmonary stenosis, RVH, overriding aorta, VSD
22q11 syndromes truncus arteriosis, tet of fallot
down syndrome ASD, VSD
congenital rubella septal defects, PDA
turner's syndrome coarctation of aorta
marfan's syndrome aortic insufficiency
offspring of diabetic mother transposition of great vessels
takayasu arteritis fFIRBOUS THICKENING OF AORTIC ARCH. dec bp in one or both arms. abdominal pain, diarrhea, GI may result from mesenteric ischemia
churg-strauss vasculitic sx's, eosinophilia, asthma
first day coag necrosis, contraction bands visible after 4 hours, release of contents of necrotic cells into bloodstream and beginning of neutrophil emigration
2-4 days RISK FOR ARRHYTHMIA. tissue surrounding infarct shows acute inflamm, dilated vessels (hyperemia), neutrophil emigration, muscle shows extensive coag necrosis
5-10 days RISK FOR FREE WALL RUPTURE. macrophages and neutrophils. granulation tissue.
7 weeks RISK FOR VENTRICULAR ANEURYSM. contracted scar complete
transmural infarct ST elevation or pathological Q waves
subendocardial infarct ST depression
dilated cardiomyopathy most common. etiologies (alcohol abuse, beriberi, coxsackie b virus myocarditis, chronic cocaine use, chaga's dz, doxorubicin toxicity, peripartum cardiomyopathy). heart dilates and looks like a baloon. systolic dysfxn ensues
hypertrophic cardiomyopathy hypertrophy often asymmetric and incolcing the intraventricular septum. normal heart size. loud S4, apical impulses, systolic murmur. diastolic dysfxn ensues. treat with beta blocker.
restrictive cardiomyopathy causes: sarcoidosis, amyloidosis, pastradiation fibrosis, endocardial fibroelastosis, endomyocardial fibrosis, and hemochromatosis
mitrial regurg holosystolic high-pitched "blowing" murmur. loudest at apex
aortic stenosis crescendo-decrescendo systolic ejection murmur following ejection click. radiates to carotids. "pulsus parvus et tardus" pulses weak compared to heart sounds
VSD holosystolic murmur
mitrial prolapse late systolic murmur wiith midsystolic click
aortic regurg immediate high pitched "blowing" diastolic murmur. wide pulse pressure
mitrial stenosis follows opening snap. delayed rumbling late diastolic murmur. (tricuspid stenosis gets louder w/inspiration)
PDA continuous machine-like murmur
virchow's triad stasis, hypercoagulability, endotheliat damage. can lead to pulm embolism
cardiac tamponade compression by fluid. quilibriation of pressure's in all 4 chambers. findings: hypotension, inc venous pressure (JVD), distant heart sounds, inc hr, pulsus paradoxus, EKG shows electrical alternans
bacterial endocarditis fever, roth spots, osler nodes, new murmur, janeway lesion, anemia, splinter hemorrhages on nail bed. multiple blood cultures nec for dz
rheumatic fever early death from myocarditis
rheumatic heart dz Aschoff bodies (granuloma with giant cells), Anitschkow's cells (activated histocytes), migratory polyarthritis, erythema marginatum, elevated ASO titers. immune mediated.
serous pericarditis caused by sle, rheumatoid arthritis, inf, uremia
fibinous pericarditis uremia, MI, rheumatic fever
hemorrhagic pericarditis TB, malignancy
loeffker;s endocarditis endomyocardial fibrosis, myocyte necrosis, prominant eosinophilic infiltrate
preggo had mumps. baby died of what? endocardial fibroelastosis
kussmal's sign inc in systemic vasc pressure on inspiration
Created by: coyleaa