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Cardio
CS- S1B2
| Name | Features |
|---|---|
| Class I | No limitation in physical activity; slight fatigue |
| Class II | Slight impairement of physical activity |
| Class III | Marked limitation of physical activity; comfortable at rest, but less than ordinary activity causes symptoms |
| Class IV | Symptoms may be present even at rest; unable to engage in any physical activity w/out discomfort |
| Most common symptoms of heart disease | Dyspnea, chest pain, palpitations, syncope, fatigue, diaphoresis, cachectic appearance |
| Dyspnea | Difficulty breathing; pp by exertion, result from left atrial+pulmonary venous pressure or hypoxia; worsening of left atrial hypertension=pulmonary edema;quantified by amount of activity that precipates it |
| Orthopnea | Dysnea that occurs in recumbency; result from increase from central venous pressure |
| Paroxysmal nocturnal dyspnea (PND) | SOB that occurs abruptly;30-2h after going to bed&is released by sitting or standing up |
| Ischemia | inadequate circulation of blood to the myocardium;usu as result of coronary a. disease d/t stenosis;sensation of discomfort;last 5-20min;tightness, pressure |
| Angina Pectoris | Coronary a. go to different parts of the heart;precordial chest pain,usu pp by stress or exertion, relieved rapidly by rest or nitrate drugs(nito=veno dilator)obstruct of coronary vess(atherosclerotic heart disease if no obstruc: L ventricular hypertrophy |
| Pain of Myocardial Infarction | if pain last longer than 20 mins then MIA |
| MI | Sudden insufficiency of arterial blood supply to the heart muscle as result of occlusion of coronary a; anxiety/sense of uneasiness;retrosternal,L precordial, protracted ischemic symptoms |
| Ischemic Pain | pp by exertion;usu relieved by rest, not related to position or respiration;if can reproduce pain by palpating then NOT heart pb; also seen with hypertrophy of either ventricles, aortic disease |
| Atypical Chest Pain | Myocarditis, cardiomyopathy, Primary pulmonary hypertension, Mitral valve prolapse |
| Palpitations | Awareness of the heartbeat;manifestation of cardiac abnormalities that increase stroke volume; cardiac dysrhytmias, PVC,SVT(supraventricular)or atrial ventricular tachycardia (VT) |
| PVC | premature ventricular contraction |
| Syncope | Loss of consciousness, faint |
| Cadiogenic syncope | at AV=no heartbeat;usu fr sinus node block AV conduction or ventricular febrillation(heart quivering, no organized activity);few prodromal sympt;cardiomyopathy;no premonitory sx: not postural hypotension |
| Neurocardiogenic syncope=vasovagal syncope | inappropriate increase in vagal efferent activity, follow brief period of duaphoresis, abrupt in onset like arrythmia-induced syncope |
| Diaphoresis | hypotension or hyperadrenergic state; seen in PERICARDIAL TAMPONADE |
| Cachectic appearance | chronic low cardiac output states |
| Central Cyanosis | d/t aterial desaturation, low output state |
| Peripheral Cyanosis | Reflects impaired tissue delivery of adequately saturated blood;poycythemia,peripheral vasoconstriction |
| Systolic pressures below 90 or more than 140 | need follow-up |
| Tachypnea | nonspecific=respiration rate more than 16/min;consider pulmonary disease+heart failure |
| Diminished peripheral pulses | result from arteriosclerotic peripheral heart disease; accompanied by localized bruits |
| Carotid pulse | valuable to assess L ventricular dunction |
| Delayed upstroke | aortic stenosis |
| Bisferiens quality | 2 palpable peaks, hypertrophic obstructive cardiomyopathy, mixed aortic regurgitation & stenosis |
| Pulsus alternans | a,plitude of pulses alternated every other beat during sinus rhythm; occurs when cardiac contractility is very depressed or w/ large PERICARDIAL EFFUSIONS |
| Pulsus paradoxus | a decrease in systolic blood pressure during inspiration more than normal 10mm Hg, valuable sign of chronic obstructive pulmonary disease (COPD) |
| Jugular Venous Pulsations | Insight into right atrial pressure;if more than 3cm above Angle of Louis: increased CVP; if rise more than 1cm w/ sustained R upper abdominal quadrant pressure (hepatojugular reflex)=increased central blood volume |
| Crackles | heard at lung bases; sign of congestive heart failure(CHF) |
| Wheezing and Rhonchi | suggest obstructive pulmonary disease but may occur in L heart failure (cardiac asthma) |
| Pleural Efllusions | w/ bibasilar percussion, dullness, and reduced breath sounds = commin in CHF |
| Edema in heart disease | results from elebated right atrial pressures |
| Pulse oximetry | shown thru capillaries, more it absorbs shows oxygen concentration in blood, red light |
| S1 | Mitral & Tricuspid valves |
| S2 | Pulmonary & Aortic valves |
| 3rd heart sound | mid-diastolic sounds |
| 4th heart sound | atrial gallop- abnormal |
| S3 | during rapid filling phase of ventricle, after closure of aortic and pulmonary valves;may be normal in children, pregnant; heart failure(ventricle dysfxn),mitral and tricuspid regurgitation(increase flow during rapid filling phase of ventricles) |
| S4 | Triple cadence to heart sounds at rate of 100/min; valve snaps back; indicative of serious disease; stiff or non-compliant ventricle |
| Clicks | high-pitched sounds. Ejection sounds |
| Murmurs | valvular disease; pansystolic when merge w/ 1st heart sound and persist thru all systole |
| Ejection murmurs | when they begin after the 1st heart sound and end before the 2nd |
| Innocent murmurs | often vary w/ inspiration, diminish in upright position; most often heard in thin individuals-esp. women |
| Thrills | palpable vibrations associated with murmurs |
Created by:
gladho
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