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CS- S1B2

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