from First Aid
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| Left Sternal Border | Diastolic Murmur:
-aortic regurg
-pulmonic regurg
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| Aortic Area | Systolic murmur: aortic stenosis, flow murmur
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| Pulmonic Area | Diastolic Murmur: pulmonic stenosis, flow murmur
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| Tricuspid area | Pansystolic murmur (triscuspid regurg, VSD), diastolic murmur (tricuspid stenosis, ASD)
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| Mitrial area | systolic murmur (mitrial regurg), diastolic murmur (mitrial stenosis)
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| CO | CO = SV*HR
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| Fick principle | CO = (rate of O2 consumption)/(artierial O2 content - venous O2 content)
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| MAP | MAP = CO*TPR
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| MAP | MAP = 2/3 diastolic + 1/3 systolic
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| PP | PP=systolic - diastolic
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| SV | SV = CO/HR = EDV-ESV
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| EF | EF = SV/EDV = (EDV-ESV)/EDV
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| R | R = P/Q = (8nl)/(pi*r^4)
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| S3 sound | at end of rapid ventricular filling, assoc with dilated CHF
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| S4 | high atrial pressure/stiff ventricle, "atrial kick" assoc with a hypertrophic ventricle
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| wide splitting of A2 & P2 | assoc with pulmonic stenosis
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| fixed splitting of A2 and P2 | assoc with ASD
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| paradoxical splitting of A2 & P2 | assoc with aortic stenosis
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| U wave | caused by hypokalemia
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| 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.
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| 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
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| a-fib | chaotic and erratic baseline (irregularly irregular) with no discrete p waves in between irregularly space qrs complexes
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| atrial flutter | rapid succesion of identical, back to back atrial depol waves. sawtooth apearance
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| 1st degree av block | PR itnerval prolonged >200ms. asympotomatic
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| 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
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| 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
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| 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
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| v-fib | completely erratic rhythm with no identifiable waves. fatal arrythmia w/o immediate CPR and defib
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| aortic arch receptor | transmits via vagus n to medulla. responds only to inc bp
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| cartoid sinus | transmits via glossopharyngeal n to medulla. responds to dec and inc in bp
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| peripheral chemoreceptors | carotid and aortic bodies respond to dec PO2 (<60mmHg), inc PCO2 and dec pH of blood
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| 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
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| Tetrology of fallot | pulmonary stenosis, RVH, overriding aorta, VSD
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| 22q11 syndromes | truncus arteriosis, tet of fallot
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| down syndrome | ASD, VSD
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| congenital rubella | septal defects, PDA
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| turner's syndrome | coarctation of aorta
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| marfan's syndrome | aortic insufficiency
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| offspring of diabetic mother | transposition of great vessels
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| takayasu arteritis | fFIRBOUS THICKENING OF AORTIC ARCH. dec bp in one or both arms. abdominal pain, diarrhea, GI may result from mesenteric ischemia
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| churg-strauss | vasculitic sx's, eosinophilia, asthma
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| first day | coag necrosis, contraction bands visible after 4 hours, release of contents of necrotic cells into bloodstream and beginning of neutrophil emigration
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| 2-4 days | RISK FOR ARRHYTHMIA. tissue surrounding infarct shows acute inflamm, dilated vessels (hyperemia), neutrophil emigration, muscle shows extensive coag necrosis
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| 5-10 days | RISK FOR FREE WALL RUPTURE. macrophages and neutrophils. granulation tissue.
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| 7 weeks | RISK FOR VENTRICULAR ANEURYSM. contracted scar complete
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| transmural infarct | ST elevation or pathological Q waves
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| subendocardial infarct | ST depression
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| 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
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| 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.
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| restrictive cardiomyopathy | causes: sarcoidosis, amyloidosis, pastradiation fibrosis, endocardial fibroelastosis, endomyocardial fibrosis, and hemochromatosis
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| mitrial regurg | holosystolic high-pitched "blowing" murmur. loudest at apex
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| aortic stenosis | crescendo-decrescendo systolic ejection murmur following ejection click. radiates to carotids. "pulsus parvus et tardus" pulses weak compared to heart sounds
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| VSD | holosystolic murmur
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| mitrial prolapse | late systolic murmur wiith midsystolic click
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| aortic regurg | immediate high pitched "blowing" diastolic murmur. wide pulse pressure
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| mitrial stenosis | follows opening snap. delayed rumbling late diastolic murmur. (tricuspid stenosis gets louder w/inspiration)
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| PDA | continuous machine-like murmur
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| virchow's triad | stasis, hypercoagulability, endotheliat damage. can lead to pulm embolism
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| 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
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| bacterial endocarditis | fever, roth spots, osler nodes, new murmur, janeway lesion, anemia, splinter hemorrhages on nail bed. multiple blood cultures nec for dz
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| rheumatic fever | early death from myocarditis
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| rheumatic heart dz | Aschoff bodies (granuloma with giant cells), Anitschkow's cells (activated histocytes), migratory polyarthritis, erythema marginatum, elevated ASO titers. immune mediated.
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| serous pericarditis | caused by sle, rheumatoid arthritis, inf, uremia
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| fibinous pericarditis | uremia, MI, rheumatic fever
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| hemorrhagic pericarditis | TB, malignancy
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| loeffker;s endocarditis | endomyocardial fibrosis, myocyte necrosis, prominant eosinophilic infiltrate
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| preggo had mumps. baby died of what? | endocardial fibroelastosis
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| kussmal's sign | inc in systemic vasc pressure on inspiration
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