Cardiac Assesment

What is the precordium

the front of the chest wall over the heart

What is the right side of the heart responsible for?

Pulmonary circulation

What is the left side of the heart responsible for?

systemic circulation

What is the base of the heart?

the top of the heart

What is the apex of the heart?

the bottom (apical pulse)

What are the 3 layers of the heart?

Pericardium, Myocardium, and endocardium

Pericardium

the protective layer that encases the heart

Myocardium

muscular layer that contracts to eject blood from the ventricles

Endocardium

lines the inner chambers and valves

Where is the heart located?

from the 2nd to 5th ICS and from the right sternal border to L mid clavicular line

AV Valves

separate atria from ventricles

Semilunar Valves

separate ventricles from great vessels

Cardiac Cycle Phases

Systole and Diastole

Systole

Ventricular Contraction

Diastole

Ventricular Relaxation (filling)

S1 sound

“lub” — start of systole

Closure of AV valves

S2 sound

“dub” — start of diastole

Closure of SL valves

Paroxysmal Nocturnal Dyspnea

Sudden episode of SOB that occurs at night

Orthopnea

SOB when lying flat

Hemoptysis

Coughing up blood

Palpitations

sensation of fluttering or fast beating heart

Abdominal aortic aneurysm (AAA)

life-threating buldge in the lower aorta that could rupture

puse deficit

discrepancy between palpated heart rate and auscultated heart rate

Why might someone have a split S2 sound

It can be normal with inspiration or abnormal when heard with inspiration and expiration caused by a conduction problem

Why might someone have a S3 sound

Fluid overload

What is a S3 sound

Ventricular gallop — sounds like Lub Dub-Da

Why might someone have a S4 sound

They have a stiff ventricle from chronic hyper tension of hx of MI

What is S4 sound

Atrial Gallop Da Lub Dub

Can a S3 sound be normal?

Yes, in pregnancy, children, or adults under 40

Can a S4 sound be normal

no!

Pericardial Friction Rub

Coarse/grating, continuous sound caused by friction between inflamed pericardial surfaces

How can you tell between a pericardial and pleural friction rub?

hold your breath

What is a heart murmur

it is a whooshing sound caused by turbulent blood flow

What is an innocent murmur

it is harmless and common in infants and children. They are quiet/difficult to hear and get quiter when standing

What is a pathologic murmur

Valve or cardiac wall defect and they are louder

What is Atrial Fibrillation

irregularly iregular heart rhythm

What is atherosclerosis

buildup of plaque in the inner lining of arteries

What is a Myocardial Infarction

It occurs when the coronary arteries are completely occulded

What is Congestive heart failure

the left and/or right ventricle fails to pump enough blood to meet the body’s needs