1. What does a heart murmur indicate? 2. Briefly differentiate between the three types of cardiomyopathies covered 3. What does the S3 heart sound indicated in patients over 35? Under 35? 4. What does the S4 heart sound indicate? 5. What part of the stethoscope does one use to listen to extra heart sounds (S3 & S4)? 6. What is a common anti-rejection medication used for transplants? Name at least one and indicate its mechanism of action. 7. Briefly explain mitral stenosis 8. Briefly explain mitral regurgitation 9. Briefly explain aortic stenosis 10. Briefly explain aortic regurgitation 11. What are valvular disorders diagnosed? 12. What clinical exam findings would point to endocarditis? 13. What clinical exam findings would point to cardiac tamponade? 14. EKG findings in tamponade? 15. EKG findings in pericarditis? 16. How is stable V-tach treated? 17. How is unstable V-tach treated? 18. How is V-fib treated? 19. Define a PVC 20. Differentiate monomorphic vs polymorphic PVCs 21. How are PVCs treated? 22. What the common etiologies for PVCs. Vtach, Vfib, SVT, or any aberrancy? 23. What is the difference between Torsades and Vtach. 24. Why do we measure: a. PR interval: b. QRS complex: c. QT interval:
1. A heart murmur indicates abnormal sounds heard during the cardiac cycle, typically due to turbulent blood flow. It can be a sign of various underlying heart conditions, including valve disorders, septal defects, or structural abnormalities.
2. Cardiomyopathies are conditions that affect the heart muscle. The three main types are:
Dilated Cardiomyopathy: Characterized by the enlargement and weakening of the heart’s left ventricle, leading to reduced pumping capacity.
Hypertrophic Cardiomyopathy: Involves the thickening of the heart muscle, particularly the ventricular septum, which can obstruct blood flow.
Restrictive Cardiomyopathy: Features stiffening of the heart muscle, limiting its ability to stretch and fill with blood properly.
3. In patients over 35, the S3 heart sound (also known as the “ventricular gallop”) can indicate heart failure or volume overload. In patients under 35, it may be a normal finding.
4. The S4 heart sound (also known as the “atrial gallop”) typically indicates reduced ventricular compliance or stiffness during diastole, often associated with conditions like hypertension or ventricular hypertrophy.
5. To listen to extra heart sounds like S3 and S4, use the bell (diaphragm) of the stethoscope, which is placed lightly on the skin.
6. A common anti-rejection medication used for transplants is Cyclosporine. It works by suppressing the immune system’s response to the transplanted organ, preventing rejection.
7. Mitral stenosis is a valvular disorder characterized by the narrowing of the mitral valve opening, which obstructs blood flow from the left atrium to the left ventricle.
8. Mitral regurgitation involves the backflow of blood from the left ventricle into the left atrium due to a dysfunctional mitral valve.
9. Aortic stenosis is a condition where the aortic valve narrows, impeding blood flow from the left ventricle to the aorta.
10. Aortic regurgitation occurs when the aortic valve does not close properly, causing blood to leak back into the left ventricle.
11. Valvular disorders are diagnosed through various methods, including physical examination, echocardiography (ultrasound), electrocardiogram (EKG/ECG), and sometimes cardiac catheterization.
12. Clinical exam findings pointing to endocarditis may include fever, heart murmur, petechiae, splinter hemorrhages, and Osler’s nodes.
13. Clinical exam findings indicating cardiac tamponade include Beck’s triad (hypotension, muffled heart sounds, and jugular venous distention) and pulsus paradoxus.
14. EKG findings in tamponade may show low voltage QRS complexes, electrical alternans, and tachycardia.
15. EKG findings in pericarditis often include diffuse ST-segment elevation and PR-segment depression across multiple leads.
16. Stable ventricular tachycardia is often treated with antiarrhythmic medications like amiodarone or lidocaine.
17. Unstable ventricular tachycardia requires immediate cardioversion or defibrillation.
18. Ventricular fibrillation is treated with immediate defibrillation to restore normal heart rhythm.
19. A PVC (Premature Ventricular Contraction) is an early heartbeat originating in the ventricles.
20. Monomorphic PVCs have a consistent QRS morphology, while polymorphic PVCs vary in QRS shape.
21. PVCs are treated if symptomatic or frequent with medications like beta-blockers or antiarrhythmics.
22. Common etiologies for PVCs include caffeine, stress, electrolyte imbalances, heart disease, or stimulant use.
23. Torsades de Pointes is a specific form of polymorphic ventricular tachycardia characterized by a twisting pattern on EKG, while Vtach is typically monomorphic.
24. The measurements serve as diagnostic tools:
a. PR interval assesses atrioventricular (AV) node function.
b. QRS complex duration indicates ventricular depolarization.
c. QT interval assesses ventricular repolarization, and prolonged QT can increase the risk of arrhythmias.
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