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Cardiology – Awesome

Murmurs, heart sounds, pulses

late peaking systolic murmur aortic stenosis
systolic murmur radiating to carotids aortic stenosis
crescendo-decresendo aortic stenosis
delayed upstroke aortic stenosis
small pulse amplitude throughout entire cardiac cycle aortic stenosis - there is a fixed obstruction
slow rising pulse aortic stenosis
midsystolic decrease in the pulse HOCM (increased LV out-tract obstruction so less flow leaving in once there is decreased volume in the LV)
secondary increase in pulse HOCM
early systolic murmur HOCM
pulsus bisferiens HOCM
Bifid pulse HOCM - referring to the decrease and then increase in pulse once the outflow tract enlarges again when volume builds up
Is there radiation to the carotids in HOCM? No
rapid upstroke, increased pulse pressure Ao insuff
rapid upstroke, nl pulse pressure MR, HOCM
One beat normal, next beat abnormal pulsus alternans in severe heart failure, tamponade
an oscillation of ventilation between apnea and hyperpnea with a crescendo-diminuendo pattern Cheyne Stokes breathing, severe heart failure, apnea leading to increased CO2 which causes excessive compensatory hyperventilation, in turn causing decreased CO2 which causes apnea, restarting the cycle
pulse decreases on inspiration so that you can't feel the pulse pulsus paradoxus (it's just an exaggeration of the normal response) - SBP decreases greater than 10 points on inspiration, you can hear heartbeat but can't feel the pulse. Increased RV filling, bulging of intraventricular septum, decreased CO
what diseases should you think about in pulsus paradoxus? Tamponade, SVC obstruction, COPD, PE
Kussmaul's sign increase in JVP on inspiration; happens in tamponade, Tricuspid stenosis, etc; trying to pull blood volume into R heart, but something wrong with R heart
decreased BP, increase HR, increased JVP, clear lungs Think R heart problem, Tamponade, SVC obstruction, COPD, PE
Auscultation of R 2nd intercostal space Ao area - Ao stenosis, Ao insufficiency; this is the R base of the heart
Auscultation of L 2nd intercostal space Pulmonic area - Pulm stenosis, Pulm insufficiency, Ao insuff, ASD
L 3rd intercostal space PDA
L lower sternal border Tricuspid area - tricuspid stenosis / ASD, tridcuspid regurg / pulm HTN, ASD
pansystolic murmur radiating to the apex Mitral regurg
pansystolic murmur radiating to the L parasternal border tricuspid regurg
machinery murmur PDA
murmur that is pan systolic AND pan diastolic PDA
opening snap and rumble mitral stenosis
diastolic murmur Ao insuff, Pulm insuff, Mitral stenosis, Tricuspid stenosis
bounding pulses Ao insuff
high pitched blowing diastolic murmur Pulmonic insuff
Austin Flint murmur Ao insuff
Apex murmurs Mitral area; Mitral stenosis, Mitral insuff, also can hear Ao insuff
palpation of the L parasternal area RV
Hyperdynamic impulse in L parasternal area increased RV volume - ASD, tricuspid insuff, VSD
Sustained L parasternal heave RV hypertrophy - mitral stenosis, Pulm HTN, pulm stenosis
Hyperdynamic impulse in the apical area increased LV volume - hyperthyroid, anemia, mitral insuff, Ao insuff with nl EF, PDA, VSD
Sustained lift / impulse at Apex LV hypertrophy - HTN, dilated cardiomyopathy, ischemic heart disease, Ao insuff with low EF
Bifid or trifid apical impulse HOCM with early systolic murmur
pansystolic / holosystolic murmurs - 3 Atrial valves - MR, TR; VSD
systolic murmurs - 4 MR, TR, PulStenosis, AoStenosis
diastolic murmurs AI, PI, Mitral Stenosis, Tricuspid stenosis
midsystolic murmur ventricular valves having to push against the outflow tracts - Pulm Stenosis, Ao Stenosis; usually crescendo-decrescendo
midsystolic CLICK MVP
Late systolic CLICK bicuspid Ao valve
friction rub heard with sitting up or leaning forward pericarditis
knock in early diastole constrictive pericarditis
late systolic murmur MVP
mid-diastolic murmur flow leaving the LA - mitral stenosis; flow leaving the RA - tricuspid stenosis
how to tell the difference between ASD and Tricuspid stenosis murmur? tricuspid stenosis increases on inspiration since increased flow to the R heart; ASD is a constant murmur
late-diastolic murmur atrial myxoma - hits the mitral opening in mid-diastole, and then murmur after that
diastolic plop atrial myxoma when it hits the mitral opening in the middle of diastole
early diastolic murmur AI, PI
Created by: christinapham



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