New PDF release: Cardiology Secrets, Third Edition

By Glenn N. Levine

ISBN-10: 0323045251

ISBN-13: 9780323045254

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Extra resources for Cardiology Secrets, Third Edition

Sample text

RV dysfunction leads to system venous hypertension, which inhibits normal reabsorption of pleural fluid into the parietal pleural lymphatics. 12. How helpful is the chest radiograph at identifying and characterizing a pericardial effusion? The CXR is not sensitive for the detection of a pericardial effusion, and it may not be helpful in determining the extent of an effusion. Smaller pericardial effusions are difficult to detect on a CXR but can still cause tamponade physiology if fluid accumulation is rapid.

Carotids—Double systolic wave. Auscultation—Decrescendo diastolic murmur along left sternal border; M1 and A2 are increased. P2 Tricuspid Regurgitation Expiration S3 S1 SM Usually secondary to pathology elsewhere in heart. Precordium—Right ventricular parasternal lift; systolic thrill at tricuspid area. Auscultation—Holosystolic murmur increasing with inspiration; other: V wave in jugular venous pulse; systolic liver pulsation. S2 S3 Expiration P2 DM S SM Atrial Septal Defect DM A2 P2 S1 Normal pulse; break parasternal life; lift over pulmonary artery; normal jugular pulse; systolic ejection murmur in pulmonic area; low pitched diastolic rumble over tricuspid area (at times); persistent wide splitting of S2.

Functional murmurs have no clinical relevance, other than getting into the differential diagnosis of a systolic murmur. 5. What is the most common systolic ejection murmur of the elderly? The murmur of aortic sclerosis. This early peaking systolic murmur is extremely age related, affecting 21% to 26% of persons older than 65 and 55% to 75% of octogenarians. ) The murmur 17 18 CHAPTER 2 HEART MURMURS 2nd right ICS listen with diaphragm for AS and radiation to the carotid arteries listen for carotid bruits left lower sternal edge listen with diaphragm for TR listen with diaphragm patient sitting forward in expiration for AR 2nd left ICS listen with diaphragm for pulmonary flow murmurs and loud P2 apex feel — location and nature listen with bell on left side and in expiration for MS listen with diaphragm for MR and listen for any radiation to axilla listen with bell for extra heart sounds Figure 2-1.

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Cardiology Secrets, Third Edition by Glenn N. Levine


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