CVS Flashcards Preview

Systems Examinations > CVS > Flashcards

Flashcards in CVS Deck (79)
1

What can be noticed on inspection of the general appearance of patients with aortic stenosis?

They are pale and sweaty

2

Why do patients with aortic stenosis appear the way they do?

Low cardiac output

3

How does the pulse feel on a patient with aortic stenosis?

Rate - elevated
Rhythm - sinus rhythm

4

What blood pressure could you expect in a patient with aortic stenosis?

100 systolic 75 diastolic

5

What pulse characteristic could you expect in a patient with aortic stenosis?

Slow rising carotid impulse
Low volume

6

Where can pulse characteristics be felt?

Brachial artery

7

Will aortic stenosis have any JVP signs? Why?

No as it is a left sided lesion.

8

What will be felt on palpating of the apex beat in a patient with aortic stenosis?

Non displaced, pressure loaded beat.

9

Can any heaves/thrills be felt on palpating in a patient with aortic stenosis?

You may feel a thrill in the aortic or carotid regions.

10

What can be heard on auscultation of aortic stenosis?

Crescendo-decrescendo systolic murmur. S2 can be heard unless stenosis is severe.

11

What can be heard in severe aortic stenosis?

A seagull noise

12

What is a pale and sweaty appearance associated with in the CVS examination?

Aortic stenosis

13

What can sinus rhythm of pulse with tachycardia, but low BP indicate?

Aortic stenosis

14

What is a slow rising carotid impulse with low volume characteristic of?

Aortic stenosis

15

What does a raised JVP indicate?

A Right sided lesions eg tricuspid regurgitation

16

With what can the apex beat be felt non-displaced but pressure loaded?

Aortic stenosis

17

With what may a thrill in the aortic region be felt?

Aortic stenosis

18

With what may a thrill in the carotid region be felt?

Aortic stenosis

19

Which valve lesion can sound like a seagull?

Aortic stenosis

20

Which valve lesion has a pansystolic murmur which has a diamond shape ie crescendo/decrescendo?

Aortic stenosis

21

What can be noticed on inspection of the general appearance of patients with aortic regurgitation?

There are 11 key signs

22

What are the peripheral signs of aortic regurgitation due to?

Volume overload

23

What are the main/most common signs of aortic regurgitation?

Quincke sign (severe AR - nail bed pulsation)
De Musset sign (head nod with pulse)
Corrigans sign (neck pulse - collapsing nature)

24

What is the pulse rate, rhythm and BP with aortic regurgitation?

Sinus rhythm
Normal HR
BP Systolic high eg 200/70

25

What pulse characteristsic can be felt with aortic regurgitation?

Collapsing pulse aka water hammer pulse
High volume

26

Is the JVP raised with aortic regurgitation? Why?

No - it is a Left sided lesion

27

Where is the apex beat felt in aortic regurgitation?

Displaced

28

How does the apex beat feel in aortic regurgitation?

Volume loaded

29

What does aortic regurgitation sound like on auscultation?

Decrescendo after S2 (start of diastole)

30

How long is the sound in aortic regurgitation?

If mild or severe, short. Use other signs to determine severity.
If moderate, long.

31

What are the 11 clinical signs including De Musset, Quincke, and Corrigans sign for?

Aortic regurgitation

32

What can normal rate and rhythm but high BP be a sign of?

Aortic regurgitation

33

What can a high volume pulse with a collapsing character be a sign of?

Aortic regurgitation

34

What can a displaced, volume loaded apex beat be an indication of?

Aortic regurgitation

35

What does an early diastolic decrescendo murmur indicate?

Aortic regurgitation

36

What can be noticed on inspection of the general appearance of patients with mitral stenosis?

Malar flush

37

How does the pulse feel on a patient with mitral stenosis?

Irregularly irregular - AF

38

Why does a mitral stenosis pulse feel the way it does?

AF due to LV dilation

39

What pulse characteristic could you expect in a patient with mitral stenosis?

Normal as does not obstruct LV outflow

40

Is JVP raised with mitral stenosis?

It may be raised due to pulmonary hypertension and cor pulmonale etc

41

What will be felt on palpating of the apex beat in a patient with mitral stenosis? Why?

Non displaced
Tapping apex beat (due to increased force of mitral valve closing)

42

Can any heaves/thrills be felt on palpating in a patient with mitral stenosis?

RV heave possible if RV dilated (assoc with raised JVP)

43

What can be heard on auscultation of mitral stenosis?

Soft diastolic sound - abscence of silence (dot dash)

44

Why can this sound be heard on auscultation of mitral stenosis?

Turbulence of flow between La and LV during diastole

45

What is malar flush associated with?

Mitral stenosis

46

What can an irregularly irregulr HR be associated with?

Mitral stenosis
AF

47

What may JVP be raised with due to increased pulmonary BP?

Mitral stenosis

48

What is a tapping apex beat (non displaced) associated with?

Mitral stenosis

49

When may a RV heave be palpable (2)?

1. Mitral stenosis if RV dilated due to pulmoary hypertension etc
2. Tricuspid regurgitation if patient has lung disease

50

What does a soft, diastolic murmur (dot dash) indicate?

Mitral stenosis

51

What can be noticed on inspection of the general appearance of patients with mitral regurgitation?

Normal appearance - tiredness or SoB may be noted from the hx

52

How does the pulse feel on a patient with mitral regurgitation?

Normal (although AF may develop if severe)

53

What is the character of the pulse felt with mitral regurgitation?

Normal

54

Is JVP raised with mitral regurgitation? Why?

No - it is not a R sided lesion

55

How does the apex beat feel with mitral regurgitation? Why?

Displaced and volume loaded as there is an active large stroke volume

56

Can anything be palpated on the chest with mitral regurgitation?

Rarely - thrill in mitral region

57

How does mitral regurgitation sound on auscultation?

Pan systolic murmur with different shapes according to cause of mitral regurgitation

58

What can make mitral regurgitation sound different?

1. Infective endocarditis - low murmur (dash dot dot)
2. Prolapse (more common) - Crescendo/wedge shaped.

59

What can a displaced apex beat that is volume loaded indicate?

Mitral regurgitation

60

What can a low pansystolic murmur indicate?

Mitral or tricuspid regurgitation caused by infective endocarditis.

61

What can a systolic murmur of increasing volume (wedge shaped) indicate?

Mitral regurgitation due to prolapsed valve

62

What can be noticed on inspection of the general appearance of patients with tricuspid regurgitation? Why?

Elephant ears - ears move due to V waves from internal jugular

63

How does the pulse feel on a patient with tricuspid regurgitation?

Normal as it is a R sided lesion

64

What pulse characteristic could you expect in a patient with tricuspid regurgitation?

Normal as it is a R sided lesion

65

Is the JVP raised with tricuspid regurgitation? Why?

Yes - S waves and V waves are present. Right sided lesion increasing preload on R side of heart

66

What may be palpable in a patient with tricuspid regurgitation?

RV heave if the patient has lung disease

67

How does tricuspid regurgitation sound on auscultation?

May have a murmur or may not depending on cause

68

What can make tricuspid regurgitation sound different?

1. Functional regurgitation - no murmur may be heard
2. Traumatic TR or infective endocarditis - low pan systolic murmur (valve must be abnormal for murmur)

69

What lesion can cause elephant ears?

Tricuspid regurgitation

70

When can elevated JVP with S waves and V waves be seen?

Tricuspid regurgitation

71

If seen with lung disease, when may a RV heave be palpable?

Tricuspid regurgitation

72

What can be noticed on inspection of the general appearance of patients with a small VSD?

Nothing - normal appearance

73

How does the pulse feel on a patient with a small VSD?

Normal

74

What pulse characteristic could you expect in a patient with a small VSD?

Normal

75

Will a small VSD have any JVP signs?

No

76

What will be felt on palpating of the apex beat in a patient with a small VSD?

It will be normal

77

Can any heaves/thrills be felt on palpating in a patient with a small VSD?

Often a thrill is palpable at the left lower sternal edge

78

What can be heard on auscultation of a small VSD?

A very loud pansytolic murmur

79

Why can this be heard in a patient with a small VSD?

Blood flow between the L side and R side ventricles due to systole