children & young adults typically but when AP dia increase it gets harder to find
what are the common or concerning symptoms for the CV sys
CP
palpitations
dyspnea
orthopnea
PND
edema
Unpleasant awareness of the heartbeat described as skipping or fluttering
palpitaions
uncomfortable awareness of breathing that is inappropriate to a given level of exertion
dyspnea
dyspnea that occurs when the patient is lying down & improves when the patient sits up
orthopnea
Orthopnea can often be seen in what
LVHF
MS
PND can often be seen in what
LVHF
MS
mimicked=nocturnal asthma attacks
Episodes of sudden dyspnea & orthopnea that awaken the patient from sleep
PND
What are the common health promotion & counseling topics for CV
hypertension screen
CHD & stroke screen
dyslipidemias screen
promoting lifestyle modification & RF reduction
what are some gen Rf's for HT
inactive
high sodium
low K
excess alcohol consumption
What defines metabolic syndrome
ATPIII
Metabolic syndrome is linked to what disorder
insulin resistance
JVP will be low with what type of patients
hypovolemic=lower bed
JVP will be high with what type of patients
hypervolemic
When does the a wave precede
b4 s1 & carotid pulse
when does the x descent happen
systolic collapse
when does the v wave happen
with S2
when does the y descent happen
early diastole
what pulse provides valuable info about cardiac fx & important for detecting stenosis or insufficiency of aortic valve
carotid pulse
what to look for when doing carotid pulse
amplitude
contour
variations in amplitude
when does a normal carotid upstroke happen in reference to s1 & s2
follows s1
precedes s2
murmur like sound of vascular rather than cardiac origin
bruit
where is S1 usually louder than S2 at
apex
where is S2 usually louder than S1 at
base
when will S1 be decreased
1st degree heart block
when will S2 be decreased
AS
A heart situated on the right side
dextrocardia
what does a sustained high amplitude impulse that is normally located suggests
LVH
what does a sustained low amplitude (hypokinetic) impulse result from
dilated cardiomyopathy
in patients with an increased AP diameter palpation of what may be useful
RV=epigastric or subxiphoid area
A palpable S2 over the pulmonic area may suggests
pulmonary HT
A palpable S2 over the aortic area may suggests
systemic hypertension
what to use to listen to the high pitch sounds of S1 & S2; aortic murmurs, mitral regurg & pericardial friction rubs
diaphragm
what to use to listen to the low pitch sounds of S3 & S4 & the murmur of MS
Bell
The rhythm of the pulse remains regular but force of arterial pulse alternates b/c of alternating strong & weak ventricular contractions. It typically occurs with L sided HF & best felt by applying light pressure on radial or femoral arteries.
pulsus alternans
what is the greater than normal drop in sys pr during inspiration