Cardiovascular - Barron's CCRN
etiology of aneurysms - arteriosclerosis
HTN
smoking/obesity
bacterial infections
congenital defects
Trauma
Marfan's syndrome (connective tissue disorder)
what other defect can cause systolic murmurs? - ventricular septal defect (heard on the left
sternal border)
relievers for Unstable angina? what do labs look like? ECG? - Nitroglycerin. Troponin negative. ST
depression or T wave inversion.
what does a decrease in systolic pressure mean if diastolic doesn't change? - This = narrowing
pulse pressure. Seen often with severe hypovolemia or a severe drop in Cardiac output.
S3 occurs where and when? - heard best at the apex of the heart right after S2
what is S3? - rapid rush of blood into a dilated ventricle
what is S4? - atrial constriction of blood into a non-compliant ventricle
Where and when does S4 occur? - Best heard over the apex with the bell right before S1
Pericardial friction rub is associated with what? - Pain during deep inspiration and positional pain
,Pulse pressure equation - systolic - diastolic = pulse pressure
normal pulse pressure values - 40-60
systolic BP represents what? - Cardiac output and stroke volume
diastolic BP represents what? - Systemic vascular resistance (SVR)
what does a decrease in diastolic BP mean? - this = widening pulse pressure. May indicate
vasodilation, severe sepsis, septic shock.
time ratio for systolic vs. diastolic - 1.0/1.33
what is perfused during diastole? - Coronary arteries
causes of valvular heart disease - - coronary heart disease
- dilated cardiomyopathy
- Degeneration
- Bicuspid aortic valve
- Rheumatic fever
- Infection
- Connective tissue diseases
murmurs of insufficiency are? - regurgitation when the valve is close
murmurs of stenosis are? - regurgitation when the valve is open
are these murmurs acute or chronic? - Stenosis = chronic
, Insufficiency = acute or chronic
systolic murmurs sound like what? - lub...shhhhh...dub
what is S3 associated with? - Heart failure, Pulmonary hypertension, cor pulmonale, and
mitral/aortic/tricuspid insufficiency
what are the valves doing during a systolic murmur? - aortic and pulmonic valve stenosis (they are
open)
Mitral and tricuspid insufficiency (they are closed)
how does a mitral valve insufficiency show up on a pulmonary artery catheter? - giant v waves
what do diastolic murmurs sound like? - lub...dub...shhhhh
what are the valves doing during diastolic murmurs? - aortic/pulmonic insufficiency (closed)
Mitral/Tricuspid stenosis (open)
mitral valve stenosis is particularly associated with what? - atrial fibrillation due to atrial
enlargement
grades of acute MI - grade 1/2 -- papillary muscle dysfunction
grade 5/6 -- papillary muscle rupture (emergency)
unstable angina = - chest pain at rest, unpredictable
NSTEMI labs? ECG? Relievers? - troponin positive. ST depression or T wave inversion. Unrelenting
pain.
etiology of aneurysms - arteriosclerosis
HTN
smoking/obesity
bacterial infections
congenital defects
Trauma
Marfan's syndrome (connective tissue disorder)
what other defect can cause systolic murmurs? - ventricular septal defect (heard on the left
sternal border)
relievers for Unstable angina? what do labs look like? ECG? - Nitroglycerin. Troponin negative. ST
depression or T wave inversion.
what does a decrease in systolic pressure mean if diastolic doesn't change? - This = narrowing
pulse pressure. Seen often with severe hypovolemia or a severe drop in Cardiac output.
S3 occurs where and when? - heard best at the apex of the heart right after S2
what is S3? - rapid rush of blood into a dilated ventricle
what is S4? - atrial constriction of blood into a non-compliant ventricle
Where and when does S4 occur? - Best heard over the apex with the bell right before S1
Pericardial friction rub is associated with what? - Pain during deep inspiration and positional pain
,Pulse pressure equation - systolic - diastolic = pulse pressure
normal pulse pressure values - 40-60
systolic BP represents what? - Cardiac output and stroke volume
diastolic BP represents what? - Systemic vascular resistance (SVR)
what does a decrease in diastolic BP mean? - this = widening pulse pressure. May indicate
vasodilation, severe sepsis, septic shock.
time ratio for systolic vs. diastolic - 1.0/1.33
what is perfused during diastole? - Coronary arteries
causes of valvular heart disease - - coronary heart disease
- dilated cardiomyopathy
- Degeneration
- Bicuspid aortic valve
- Rheumatic fever
- Infection
- Connective tissue diseases
murmurs of insufficiency are? - regurgitation when the valve is close
murmurs of stenosis are? - regurgitation when the valve is open
are these murmurs acute or chronic? - Stenosis = chronic
, Insufficiency = acute or chronic
systolic murmurs sound like what? - lub...shhhhh...dub
what is S3 associated with? - Heart failure, Pulmonary hypertension, cor pulmonale, and
mitral/aortic/tricuspid insufficiency
what are the valves doing during a systolic murmur? - aortic and pulmonic valve stenosis (they are
open)
Mitral and tricuspid insufficiency (they are closed)
how does a mitral valve insufficiency show up on a pulmonary artery catheter? - giant v waves
what do diastolic murmurs sound like? - lub...dub...shhhhh
what are the valves doing during diastolic murmurs? - aortic/pulmonic insufficiency (closed)
Mitral/Tricuspid stenosis (open)
mitral valve stenosis is particularly associated with what? - atrial fibrillation due to atrial
enlargement
grades of acute MI - grade 1/2 -- papillary muscle dysfunction
grade 5/6 -- papillary muscle rupture (emergency)
unstable angina = - chest pain at rest, unpredictable
NSTEMI labs? ECG? Relievers? - troponin positive. ST depression or T wave inversion. Unrelenting
pain.
