Term
|
Definition
Delayed pulmonic closing, splitting with inspiration only
Lungs enlarge, more flow, pulmonic closes later
(aortic closes ~ earlier due to decrease return to L heart) |
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Term
|
Definition
Delayed RV emptying, splitting even without inspiration, expands with inspiration
Pulmonic stenosis, RBBB |
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Term
|
Definition
Left-to-right shunt, no change with inspiration
Due to ASD |
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Term
|
Definition
Delayed LV emptying, aortic valve closes AFTER pulmonic valve. Split reduces on inspiration, "paradoxically"
Aortic stenosis, LBBB |
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Term
Holosystolic, high-pitched "blowing" murmur
Loudest at apex, radiates to axilla
Enhanced by squatting, hand grip |
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Definition
Mitral regurgitation
ischemic heart disease, mitral valve prolapse, LV dilation, rheumatic fever |
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Term
Holosystolic, high-pitched "blowing" murmur
loudest at left sternal border 4th ICS
Enhanced by inspiration |
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Definition
Tricuspid regurgitation
RV dilation, endocarditis |
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Term
Crescendo-decrescendo systolic murmur following click
Radiates to apex and carotids
Weak pulses |
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Definition
Aortic stenosis & "pulsus parvus et tardus"
Age-related calcific changes, bicuspid aortic valve |
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Term
Holosystolic, harsh murmur in acyanotic infant
Loudest at L sternal border 4th ICS |
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Definition
VSD
most common congenital cardiac abnormality |
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Term
Late systolic crescendo murmur after click
Earlier click with valsalva, louder murmur with handgrip |
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Definition
Mitral valve prolapse
valsalva - decreased LV return, lax chordae
handgrip - increased TPR, more backflow
Myxomatous degeneration, rheumatic fever, chordae rupture |
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|
Term
Early, high-pitched "blowing" diastolic murmur
Wide pulse pressure |
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Definition
Aortic regurgitation
aortic root dilation, bicuspid valve, rheumatic fever |
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|
Term
Low-pitched diastolic murmur following click
Enhanced by expiration |
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Definition
Mitral stenosis
expiration = increased L atrial return
rheumatic fever (most common) |
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Term
| Continuous systolic>diastolic murmur in infant |
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Definition
Patent ductus arteriosus (PDA)
congenital rubella, prematurity |
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Term
| ECG: erratic baseline, no discrete P waves, irregularly-irregular QRS. |
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Definition
|
|
Term
| ECG: rapid, identical "sawtooth" waves under QRS complexes |
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Definition
|
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Term
|
Definition
|
|
Term
| Progressive lengthening of PR interval, until missing QRS complex |
|
Definition
2nd degree AV block
Mobitz type I, "Wenckebach" |
|
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Term
| Missing QRS complexes, not preceded by lengthening PR interval. Usually 2:1 P:QRS |
|
Definition
2nd degree AV block
Mobitz type II |
|
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Term
| Complete independence of atrial and ventricular depolarizations |
|
Definition
3rd degree AV block
(can be caused by Lyme disease) |
|
|
Term
| Erratic rhythm, no identifiable waves |
|
Definition
|
|
Term
Normal pressures:
RA?
RV?
PulmArtery?
LA (PCWP)?
LV?
Aorta? |
|
Definition
RA: 0-5
RV: 5-20
PulmArt: 10-20
LA (PCWP): 0-10
LV: 10-120
Aorta: 80-120 |
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Term
|
Definition
| Uncorrected VSD, ASD, or PDA causes compensatory RV hypertrophy. Shunt eventually reverses from L->R to R->L, leading to late presenting cyanosis. |
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Term
Evolution of MI
2-4 hrs
4-12 hrs
12-24 hrs
1-5 days
5-10 days
10-14 days
2wks-2months |
|
Definition
2-4 hrs: no visible change by light microscopy
4-12 hrs: early coagulative necrosis
12-24 hrs: contraction bands, coagulative necrosis
1-5 days: neutrophil infiltration, inflammation, arrythmia risk
5-10 days: macrophage infiltration, complete degradation, risk for wall rupture, tamponade
10-14 days: granulation tissue, neovascularization
2wks-2months: collagen deposition, contracted scar, risk for ventricular aneurysm |
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|
Term
MI diagnosis
First 6 hours
after 4 hours |
|
Definition
first 6 hours: ECG (ST changes, Q waves)
after 4 hours: Cardiac troponin I, elevated for 7-10dys |
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|
Term
ECG MI location:
V1-V4
V1-V2
V4-V6
I, aVL
II, III, aVF |
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Definition
V1-V4: Anterior (LAD)
V1-V2: Anteroseptal (LAD)
V4-V6: Anterolateral (LCX)
I, aVL: Lateral wall (LCX)
II, III, aVF: Inferior wall (RCA) |
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Term
| What is Dressler's syndrome? |
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Definition
| several weeks post-MI, auto-immune fibrinous pericarditis |
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|
Term
S3?
S4?
Kussmaul sign & pulsus paradoxus? |
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Definition
S3: dilated cardiomyopathy
S4: hypertrophic cardiomyopathy
Kussmaul sign & pulsus paradoxus: restrictive cardiomyopathy/pericarditis |
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Term
| Libman-Sacks endocarditis |
|
Definition
| Verrucous (warty) sterile vegetations on both sides of valve. Most often benign, or mitral regurg/stenosis. Seen in SLE. |
|
|
Term
| Which valves affected in rheumatic heart disease? |
|
Definition
high pressure valves
mitral > aortic >> tricuspid |
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|
Term
Most common primary cardiac tumor in adults
multiple syncopal episodes |
|
Definition
Myxoma - most in left atrium
"ball valve" obstruction of mitral valve |
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Term
|
Definition
Granulomatous vasculitis with eosinophilia
Asthma, sinusitis, skin lesions, peripheral neuropathy
p-ANCA positive |
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Term
|
Definition
Granulomatous thickening of aortic arch/great vessels; "pulseless disease"
asian females < 40 yrs old
increased ESR
Fever, Arthritis, Night sweats, Myalgias, Skin nodules, Ocular disturbances, Weak pulses
FAN My Skin, OW! |
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|
Term
| When is greatest risk of free-wall rupture post-MI? |
|
Definition
3-7 days
(mean 4-5 days, range 1-10) |
|
|
Term
| What feature of a mitral stenosis heart sound is most closely related to severity? |
|
Definition
S2 to OS interval: shorter means more severe MS.
Opening snap (OS) is caused by valve leaflets tensing AFTER they open. If stenosis is severe, LA pressure will be elevated and mitral valve will open sooner (LA pressure will be greater than LV pressure sooner). |
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Term
|
Definition
Primary hyperaldosteronism; ex. aldo secreting tumor
HTN, hypokalemia, metabolic alkalosis, low renin.
Fatigue, muscle weakness, headaches.
Treat with spironolactone or eplerenone, surgery. |
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Term
|
Definition
Kidney: dilates afferent arteroles, increases GFR and Na/H2O excretion. Limits Na reabsorption and inhibits renin secretion.
Adrenals: inhibits aldosterone secretion.
Blood vessels: Relaxes vascular smooth muscle, increases capillary permeability. |
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Term
Jervell and Lange-Nielsen Syndrome vs.
Romano-Ward Syndrome |
|
Definition
Both are congenital long QT syndromes. Both due to defects in K+ channels. Lead to unproved arrythmia, syncope.
J & L-N: Rare, AR, w/ neurosensory deafness.
R-W: More common, AD, w/o deafness. |
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Term
Systolic vs. Diastolic heart failure:
Left ventricular volume?
Left ventricular ejection fraction?
Left ventricular end-diastolic pressure? |
|
Definition
Systolic
LV vol: increased
LV EF: decreased
LVEDP: increased
DIASTOLIC
LV vol: normal
LV EF: normal
LVEDP: increased
*systolic is decreased contractile performance, requiring increased end-diastolic volume and pressure to maintain stroke volume. Diastolic is decreased compliance only; so only pressure needs to rise to maintain stroke volume. |
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