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PDX : Heart

Terms in this set (62)

The most lateral pulsation that can be seen
Apex beat
If a patient presents with an exaggerated apex beat, this suggests what?
Hypertrophy of the left ventricle
If a patient presents with a displaced apex beat, this suggests what?
Volume overload, dilation of the left ventricle
Neck vessels visible ______cm above the suprasternal notch is considered abnormal.
Two
True or False : The jugular filling level will drop inferior as the patient inhales?
True, blood and air are sucked into chest cavity with inspiration
Increased venous waves suggests what?
High pressure in right atrium (right sided heart problems)
Absence of venous pulsation indicates what?
Normal pressure changes from right atrium are blocked.
This is a paradoxical increase in the vein column during inspiration. Suggests constrictive pericarditis with tamponade
Kussmauls Sign
Tracheal tug upon inspiration suggests what?
Aortic Aneurysm
Patient presents with a pulse that arrives late and is weak. What is this called and what does it suggest?
Pulsus Tardus, suggests aortic valve stenosis
This type of pulse occurs with high pulse pressures, usually a hammering force. What does it suggest?
Water-hammer pulse, suggests aortic regurgitation
When palpating the aortic and pulmonic areas of your patient, you feel a vibration (murmur). What does this indicate?
Valve problems (turbulent flow)
When palpating over the mitral area, you feel a thrill. What does this suggest?
Mitral Valve stenosis
The sensation of a strong pulsation in the suprasternal notch suggests what?
Aortic Aneurysm
True or False : When auscultating over the carotid artery, it is not important to ask the patient to stop breathing.
False, ask the patient to hold their breath to eliminate tracheal sounds.
True or False : The first sound, also known as "lub" occurs during the closure of the mitral and tricuspid valves
True
True or False : Systole is longer than diastole?
False ; systole is shorter than diastole
True or False : The second sound, also known as "dub" occurs during the closure of the mitral and tricuspid valves?
False ; occurs during the closure of the aortic and pulmonic valves
Which side of the heart fills more and takes longer to empty during inspiration, causing the physiological S2 splitting sound?
Right side
What are instructions you can give your patient to better hear a physiological split?
Lean forward and take a deep breath to hold
A harsh sound produced from turbulent flow, usually from bad valves.
Heart murmur
This is an abnormal sound heard between S1 and S2.
Systolic murmur
What is a pathological cause of a systolic murmur?
Aortic stenosis
What is a pathological cause of a diastolic murmur?
Mitral stenosis, Aortic regurgitation
A narrowing of a valve is known as?
Stenosis
This is when a valve does not close tightly which allows for backward flow of blood.
Insufficiency / Regurgitation
This is known as recurrent attacks of tachycardia, has an abrupt onset and often abrupt termination
Paroxysmal Tachycardia
When your heart beats less than 60BPM
Bradycardia
Non-specific symptom often of excessive tiredness. Most common sign of heart dysfunction.
Fatigue
Name two causes of chest pain
1) Coronary artery disease
2) Pericardial disorders
3) Valve problems compromising blood flow
There may be more...
Paroxysmal pain in chest, often associated with myocardial ischemia
Angina Pectoris
What is Levines Sign?
Fist clenched (squeezing) over the precordium
Extreme, generalized infiltration of edema fluid into subcutaneous connective tissue.
Anasarca
Also known as a problem with rate or rhythm. Accompanied by dizziness, blurred vision, syncope, and weakness
Arrhythmia
When a patient has decreased heart rate and force of contraction, they often undergo this type of spell.
Vagal Faint (Vasovagal Syncope)
Forcible or irregular pulsations of the heart often perceptible to the patient.
Palpitations
When are palpitations deemed more concerning?
After activity
Very common form of heart disease where there is poor perfusion of the myocardium, usually to plaque buildup in the coronary arteries.
Ischemic Heart disease
Death of an area of the heart muscle, results from occlusion of one or more coronary arteries.
Myocardial Infarction
A patient comes in complaining of chest pain. You take blood work and find increased white count, increased levels of creatine kinase. How long ago did the patient experience a MI?
2-4 hours initially started, returns to normal after 48 hours
A patient comes in complaining of chest pain. You take blood work and find increased levels of serum aspartate transaminase. How long ago did the patient experience a MI?
4-6 hours after initial attack, peaks 24-48 hours, returns normal after 5 days.
A patient comes in complaining of chest pain. You take blood work and find increased levels of lactate dehydrogenase. How long ago did the patient experience a MI?
Increases about 24 hours after attack, returns to normal about 10-20 days later.
Characterized by heart muscles undergoing hypertrophy, more oxygen is required to supply the increase in muscle mass, leading to pump failure.
Hypertensive heart disease
Heart can no longer eject enough oxygen rich blood
Systolic congestive heart failure
Heart muscles are too stiff and do not fill
Diastolic congestive heart failure
Patient presents with tachycarida, pulsus alternans, and a sustained heave at the apex. What is your diagnosis?
Left Congestive Heart failure
Patient presents with elevated JVD, Kussmaul sign, and tachycardia. The patient also has a heave under the sternum and anterior chest wall. What is your diagnosis?
Right Congestive Heart failure
Increase in lung resistance to blood flow which causes right sided hypertensive heart disease, without left sided heart failure.
Cor Pulmonale
Patient presents with Pedal edema, cyanotic face with prominent neck and facial veins. During auscultation you hear a splitting of S2 with S3 or S4 sounds. You also notice the patient has ascites. Diagnosis?
Cor Pulmonale
The mnemonic ASC stands for what? And what does it indicate?
ASC - Angina & Syncope & CHF. Indicates Aortic stenosis
Patient presents with no observational issues. Upon palpation they have reduced pulses, and a palpable S4 at the apex. During auscultation you hear a late systolic ejection murmur. What is your diagnosis?
Aortic Stenosis
Patient presents with no real observational issues. Upon palpation you feel tachycardia, and cool extremities. During auscultation of the heart you hear a loud sharp S2, with a lub pewww sound with patient seated and leaning forward. Diagnosis?
Acute Aortic Regurgitation
What are two major causes of mitral valve stenosis?
Rhuematic fever or congential
Patient presents with Levines sign. During palpation you feel a S1 thrill at the apex with heaves. During auscultation you hear a diastolic murmur that worsens with Valsalva, also a loud S1. Diagnosis?
Mitral Valve Stenosis
Patient presents with edematous feet or ankles, as well as a displaced apex beat. During palpation you feel a regurgitation thrill. During auscultation you hear a holosystolic murmur at the apex. Diagnosis?
Mitral Regurgitation
Patient presents with no observational or palpational findings. Upon auscultation, you hear a mid-systolic click after a normal S1 sound. It is increased during Valsalva. Diagnosis?
Mitral Valve prolapse
Patient presents with abdominal bloating and JVD. Upon palpation you feel an enlarged liver. During auscultation you have a hard time determining if S2 is split, and S1 is barely audible. Diagnosis?
Tricuspid Regurgitation
This is muscular enlargement of the heart due to pumping at high pressures. This causes the PMI/apex beat to move to the left.
Cardiac Hypertrophy
Patient feels pain in his chest region. Upon performing tests, you find that the layers around the heart have become sticky and cardiac output has decreased due to fluid buildup. Diagnosis?
Pericarditis
Compression of the heart due to critically increased volume of the fluid in the pericardium
Acute pericardial tamponade
Inflammation of the endocardium caused by bacteria spreading throughout the blood stream.
Endocarditis
A younger patient presents with fever following an infection of the throat. He is exhibiting chest pain, and this is not the first time this has happened in his life. What are you suspecting?
Rheumatic Fever (relapses are common from repeated streptococcal infections)
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