Cardiac Abnormalities - Nordgren

Question 1

Explain the mechanism by which stenosis or insufficiency can cause edema:

Answer 1

These two valve problems can create increased pressure in the upstream capillary beds. If the hydrostatic pressure through capillaries is great enough, it will continue to be greater than the oncotic pressure creating reabsorption back into capillaries. This will cause the interstitial fluid build-up of edema.

Question 2

What kind of murmur is seen in aortic stenosis?

Are there any changes in the pulse pressure?

Answer 2

Aortic stenosis causes a systolic murmur due to the high ejection velocity.

The pulse pressure is actually lower than normal.

Question 3

How might aortic stenosis affect axis deviation?

Answer 3

Cardiac muscle hypertrophy and increased left ventricle muscle mass causes a LEFT Axis Deviation.

Question 4

What kind of murmur would you see in a mitral valve stenosis?

Can you think of where you might get hypertrophy in this disorder?

Answer 4

Diastolic murmur due to turbulent flow through the mitral valve.

Hypertrophy can occur in the left atrial muscle.

Question 5

What kind of murmur is heard in aortic insufficiency?

Answer 5

Diastolic murmur

-Blood is rushing back into the LV from the aorta during diastole

Question 6

What are you going to hear if the aortic valve is both stenotic and insufficient?

Answer 6

You will get diastolic and systolic murmurs

occurs relatively often

Question 7

What are the 2 primary physiological consequences of aortic insufficiency?

Answer 7

-Reduced ejection fraction
-Increased volume workload
(Think about what is happening to the blood in this murmur and these two should make sense)

Question 8

If the leaflets of the mitral valve do not close, what is this called?

What kind of murmur will it cause?

Answer 8

Mitral regurgitation
(Blood is allowed to regurgitate from the LV to the LA during systole)

Will cause Systolic murmur

Question 9

What is it called when the leaflets of the mitral valve actually evert into the left atrium during systole?

Answer 9

Mitral prolapse - the most common form of mitral regurgitation

Question 10

Name some of the indicators of a normal lead II tracing:

Answer 10

• Frequency of QRS = ~1/sec
• Normal QRS shape
• QRS < 100 msec duration
• Each QRS preceded by p wave
• PR < 200 msec
• QT < R-to-R interval
• No extra P waves