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Cardiology – Awesome

Maneuvers that determine flow to the heart

QuestionAnswer
Leg raise increase venous return to heart
sitting increase venous return to heart
squatting increase venous return to heart
valsalva decrease venous return to heart
standing decrease venous return to heart
least amount of blood to the heart is when? Valsalva on inspiration
hand grip increased afterload
after PVC after the compensatory pause, we have decreased afterload; quick decrease in ventricular volume
What happens to HOCM murmur with sitting / leg raise / squatting? increased volume to heart --> decreased murmur
What happens to HOCM murmur with valsalva on inspiration or standing? decreased volume to heart --> increased murmur
What happens to HOCM murmur with hand grip? decreased
What happens to HOCM murmur after PVC? increased since there is increased obstruction as ventricular volume decreases
What happens to MVP murmur with sitting / leg raise / squatting? increased volume to heart --> valve flops later --> decreased duration of murmur
What happens to MVP murmur with valsalva on inspiration or standing? decreased volume to heart --> valve flops earlier --> increased duration of murmur
mid systolic click, late systolic murmur MVP
What happens to MVP murmur with hand grip? increased after load --> more volume in heart --> later flop (decreased murmur duration), but increased intensity of murmur once flow gets out
What happens to MVP murmur after PVC? decreased after load --> volume in heart decreases fast --> earlier flop (increased murmur duration), but decreased intensity of murmur once flow gets out
what valvular defect is associated with cardiac conduction defects aortic stenosis
What happens to aortic stenosis murmur with sitting / leg raise / squatting? increased venous return --> increased murmur
What happens to aortic stenosis murmur with valsalva on inspiration or standing? decreased venous return --> decreased murmur
What happens to aortic stenosis murmur with hand grip? increased after load --> decreased flow through the valve --> decreased murmur
What happens to aortic stenosis murmur after PVC? decreased after load --> increased flow through the valve --> increased murmur
least flow to the R heart valsalva on expiration
least flow to the L heart valsalva on inspiration
what happens to murmurs on inspiration? increased flow to the R heart -- R-sided murmurs increase
what happens to murmurs on expiration? increased flow to the L heart - L sided murmurs increase (except for HOCM and MVP)
what happens to flow to the heart with phenylephrine increased after load
what happens to flow to the heart with amyl nitrite decreased after load
which murmurs increase with standing/valsalva? MVP and HOCM
which murmurs increase with squatting/sitting? all murmurs except MVP and HOCM
which murmurs increase with hand grip? increased after load --> all murmurs including MR, MVP decreased duration increased intensity
which murmurs decrease post PVC? decreased after load --> MVP increased duration but decreased intensity
which murmurs decrease with hand grip? increased after load so murmurs that decrease are: HOCM more volume in the ventricle, AS decreased flow through the valve, MVP valve flops later --> decreased murmur duration but increased intensity
which murmurs increase post PVC? decreased after load - AS because increased flow through the Ao valve, MVP increased duration but decreased intensity, HOCM increases
Created by: christinapham