Viva Questions of CVS by Dr Junaid

Summary

Dr. Gianetti from Aurora's new Medical University presents a comprehensive overview of pediatric cardiology in an examination setting. The lecture covers a range of topics including causes of tachycardia and bradycardia, types of pulses and murmurs, grades of murmurs, and characteristics of heart sounds. It delves into the specifics of systolic and diastolic murmurs, epic speed variations, and the clinical implications of palpable and impalpable epic speed. The talk is designed to prepare medical students for the rigors of clinical examinations, emphasizing the importance of understanding cardiac auscultation and its diagnostic significance.

Takeaways

• 📝 Dr. Gianetti is a senior in Pediatrics at Aurora New Medical University and will discuss various heart examination questions.
• 💓 Tachycardia can be caused by conditions like anxiety, heart failure, anemia, and tachyarrhythmias.
• 🔽 Bradycardia may be due to hyperthyroidism, leads, heart block, and certain drugs like digoxin.
• 👉 Relative bradycardia is associated with conditions such as hypothyroidism, direct trauma, infections, and increased intracranial pressure.
• 🌊 Shift of epicardial beat can be due to mitral regurgitation, aortic regurgitation, hypertension, ischemic heart disease, and other factors.
• 🚫 Causes of impalpable epicardial beat include thick chest wall, emphysema, and pericardial effusion.
• 🔨 Tapping epicardial beat is present in conditions where the first heart sound is loud, such as aortic stenosis.
• 💨 Heaving epicardial beat occurs when the heart has to eject a large volume of blood, as in aortic regurgitation.
• 🔊 Soft heart sounds can be caused by pericardial effusion, emphysema, or a thick chest wall.
• 📉 Loud P2 can be due to primary hypertension, while loud S1 is often associated with mitral stenosis.
• 🔍 The script also covers the grading of heart murmurs, with six degrees ranging from barely audible to audible without a stethoscope.

Q & A

What are the causes of tachycardia mentioned in the script?

The causes of tachycardia include anxiety, heart failure, anemia, and tachyarrhythmias.

What factors can lead to bradycardia according to the script?

Bradycardia can be caused by hyperthyroidism, heart block, and drugs such as digoxin, as well as increased intracranial pressure.

What are the causes of relative bradycardia?

Relative bradycardia can be caused by deep breathing, severe infections, and increased intracranial pressure.

What are the different types of pulses discussed in the script?

The script does not provide specific types of pulses, but it does mention various heart conditions and murmurs which can affect pulse characteristics.

What are the grades of murmurs and how many are there?

There are six grades of murmurs, ranging from grade one, where the murmur is heard with extreme difficulty, to grade six, where the murmur is audible even without a stethoscope.

What causes a pansystolic murmur?

Pansystolic murmurs are caused by conditions such as mitral regurgitation, tricuspid regurgitation, and ventricular septal defect.

What is the cause of an ejection systolic murmur?

An ejection systolic murmur is produced when the heart has to eject against a narrow passage, such as aortic stenosis or pulmonary stenosis.

What does the pitch of a murmur indicate?

The script does not provide specific information about the pitch of a murmur, but generally, a higher pitch may indicate a more severe stenosis or regurgitation.

What are the causes of a loud P2 heart sound?

A loud P2 heart sound can be caused by conditions such as primary hypertension.

What are the causes of a soft heart sound?

Soft heart sounds can be caused by conditions such as pericardial effusion, emphysema, or a thick chest wall.

What are the characteristics of a tapping apex beat?

A tapping apex beat is present when the first heart sound (S1) is soft and loud, and may be sustained or not, depending on conditions such as mitral regurgitation or aortic stenosis.

Outlines

00:00

👨‍⚕️ Medical Examination of Heart Sounds and Conditions

Dr. Gianetti and Revathi from Aurora New Medical University discuss various cardiac examination questions. They cover the causes of tachycardia and bradycardia, different types of pulses and murmurs, and the grading of murmurs. They delve into the specifics of systolic and diastolic murmurs, the pitch and character of heart sounds, and the conditions that affect the palpability and intensity of these sounds. They also mention the causes of soft heart sounds and loud P2, and the importance of understanding the characteristics of murmurs in diagnosing heart conditions.

05:02

🔍 Advanced Cardiac Assessment Techniques

This paragraph continues the medical lecture on cardiac examination, focusing on advanced assessment techniques. It discusses the different grades of murmurs and their audible characteristics, the causes of pansystolic and ejection systolic murmurs, and the physiological conditions that lead to these sounds. The paragraph also addresses the impact of patient positioning on the audibility of murmurs and the types of murmurs associated with specific heart conditions. Additionally, it touches on the examination of the precordial area for signs of heart failure and other relevant clinical signs.

Keywords

💡Tachycardia

Tachycardia refers to a heart rate that is abnormally fast, typically over 100 beats per minute in adults. In the context of the video, it is one of the key cardiac conditions discussed. The script mentions causes such as anxiety, heart failure, anemia, and tachyarrhythmias, which are all medical conditions that can lead to an increased heart rate.

💡Bradycardia

Bradycardia is the opposite of tachycardia, characterized by a heart rate that is slower than normal, typically below 60 beats per minute. The video script discusses causes such as hyperthyroidism, heart block, and the influence of certain drugs like digoxin, which can slow down the heart rate.

💡Pulse

Pulse refers to the rhythmic expansion and contraction of an artery as blood is pumped through it by the heart. The video script mentions different types of pulses, indicating that the characteristics of a pulse can provide insights into a patient's cardiovascular health.

💡Murmur

A murmur is an abnormal sound heard during the auscultation of the heart, which can indicate the presence of a heart condition. The script discusses different types and grades of murmurs, which are crucial for diagnosing various heart diseases.

💡Grades of Murmurs

The grading of murmurs is a clinical assessment that quantifies the intensity of a heart murmur. The script specifies six degrees of murmurs, ranging from barely audible to those heard even without a stethoscope, which helps in understanding the severity of a cardiac condition.

💡Systolic Murmurs

Systolic murmurs occur during the systole phase of the heart cycle when the heart is contracting. The script refers to the powers of systolic murmurs, indicating that the loudness and characteristics of these murmurs can be indicative of certain heart problems, such as aortic stenosis.

💡Diastolic Murmurs

Diastolic murmurs are heard during the diastole phase when the heart is filling with blood. The script mentions the causes of diastolic murmurs, such as mitral stenosis, which can lead to abnormal heart sounds during this phase.

💡Epic Speed

Epic speed, or epicardial speed, refers to the palpable heartbeat, which can be felt on the chest wall. The video script discusses different types and causes of changes in epic speed, such as tapping or heaving, which are significant in diagnosing heart conditions.

💡Apex Beat

The apex beat is the point of maximum impulse of the heart, felt during a physical examination. The script mentions causes for shifts in the apex beat, such as chest deformities or lung diseases, which can affect the location where the heartbeat is most prominently felt.

💡Heart Failure

Heart failure is a condition where the heart cannot pump blood effectively. The script discusses signs to look for in determining if a patient is in heart failure, such as peripheral edema or crackles in the chest, which are critical for diagnosis.

💡Cardiac Auscultation

Cardiac auscultation is the medical practice of listening to the internal sounds of the heart using a stethoscope. The video script emphasizes the importance of this technique in identifying various heart conditions through the assessment of murmurs and other sounds.

Highlights

Dr. Gianetti, a senior in Pediatrics at Aurora University, discusses various questions related to cardiac examination.

Causes of tachycardia include anxiety, heart failure, anemia, and tachyarrhythmias.

Bradycardia can be caused by hyperthyroidism, heart block, and certain drugs like digoxin.

Relative bradycardia is associated with conditions like hypothyroidism, lead poisoning, and increased intracranial pressure.

Different types of pulses and murmurs are discussed, including their characteristics and causes.

Murmurs are graded from one to six, with grade one being the softest and grade six the loudest.

Pansystolic murmur is caused by conditions such as mitral regurgitation and tricuspid regurgitation.

Ejection systolic murmurs occur when the heart has to eject against a narrow passage, such as aortic stenosis.

Pitch, character, and radiation of murmurs are important aspects in diagnosing heart conditions.

Third and fourth heart sounds are discussed, along with their causes and clinical significance.

Epic speed variations, such as tapping and heaving, are explained in relation to different cardiac conditions.

Causes of impalpable epic speed include thick chest wall, emphysema, and pericardial effusion.

Tapping epic speed is associated with conditions like aortic regurgitation and mitral regurgitation.

Soft heart sounds can be caused by pericardial effusion, emphysema, or a thick chest wall.

Loud P2 is indicative of conditions like primary hypertension, while loud S1 is associated with mitral stenosis.

The characteristics of murmurs, such as harshness and blowing nature, help in diagnosing stenosis and regurgitation.

Clinical examination techniques, such as precordial palpation, are crucial for diagnosing heart failure.

Signs of heart failure include crackles in the chest and peripheral edema, which are important for clinical assessment.

Transcripts

assalamu alaikum I am dr. Gianetti

Revathi and I am senior is draw in

Pediatrics Aurora new Medical University

today I am going to talk about the

different wave of questions that can be

asked in examination of recording and

the relevant the students may be asked

about what are the causes of tachycardia

one of the causes of bradycardia what

are the causes of rarity bradycardia

what are the different types of pulses

what are the different types of murmurs

what are the grades of murmurs what are

the powers of systolic murmurs one of

the guards of diastolic murmurs what are

the cause of pansystolic murmur what are

the causes of ejection systolic murmur

what do you mean the pitch of a murmur

what is the character of Omaha what is

intensity of Naga what is radiation of

Marmara which members exaggerate on

making the pollution laughs literal

which mother exaggerate on sitting

abandoning forward which member radiates

to the left shoulder which member

radiates to the neck murmur

radiates to the axilla and what are the

causes of third heart song what are the

causes of fourth heart sign and what is

epic speed their epic speed is felt what

are the different types of epic speed

what is tapping having speed what is

heaving epic speed

what is ill sustained leave what is well

sustained heal then what are the causes

of shift of epic speed what are Hardy

causes of shift of effect speed

what have non particles of shift of

effects made what are the causes in

which the epic speed is impalpable now

let's talk about in detail about these

power questions when the examiner asks

you about the key Korea then you need to

tell the causes of technicality through

feeble third opsin causes anxiety and

heart failure anemia tachyarrhythmias

when the examiner asks you about the

cost of bradycardia then you need to

tell about hyperthyroidism leads and

heart block and drugs like digoxin and

raise internal pressure when the

examiner asked you about causes of

relative bradycardia

they include and direct we were habitats

is like very infections and many jet is

two degrees internal pressure then and

then the examiner asks you about causes

of shift of epochs beat the positive

shift of FX which you drew the cardi

causes in the narcotic crosses the Qadri

causes include the mitral regurgitation

in the aortic regurgitation in the non

along with hypertension ischemic heart

disease and the Namrata causes of shift

of epic speech includes the left letter

or sitting for position of the patient

deformities of the chest and pulmonary

diseases engine and then the examiner

may ask you about what are the causes of

impalpable

epic speed the epic speed can be

impaired will can be impeccable with

this is a thick chest war with this is

destacar dr and then there is emphysema

there is a pericardial effusion then the

atmosphere may be impalpable and then he

then he may ask you what are the cause

of tapping epic speech the tapping of

epic speed is present in when the first

are so much lord loud and that is -

gnosis when there is he it may be

insistent it may be well sustain the

insistent if when the heart has to eject

a large volume of blood like in three

girls blood on a average an equivalent

PGI or at the heart of palm come apart

ah to squeeze it it'll sustain heave up

the air like mitral regurgitation and

like your degree vegetation

and well sustain he is been hard has to

eject against high resistance RB

decisions are that like have attention

like a optic stenosis and then the

examiner may asks you about work because

of soft heart songs with this

pericardial effusion when there's

emphysema in this thick chest wall the

heart songs may become soft yeah the

causes of loud p2 includes primary

hypertension and the causes of loud s1

include mitral stenosis about my de

sousa you need to know about two three

points the cause of love first not song

is madness gnosis all the members are

high-pitched except madness Knossos the

mother which exaggerates on Lafayette

Revolution is Myra stenosis so these are

three points about metastasis the member

which exaggerated to the left shoulder

is poppin the restenosis the memory is

rates to the neck is periodic stenosis

the murmur which existed which radiates

to the axilla is margin regurgitation

the murmur which becomes prominent with

the position when the patient takes life

leader position is - no sir

the murmur which becomes prominent when

the patient six ups and lean forwards is

the aortic regurgitation and the panel

is the vegetation air and B are the

members of right heart they increase in

intensity during inspiration in the

murmurs of nafta the increase in

intensity during expiration the murmurs

of stenosis

they are harsh or then harsh in in

cattle and the members of regurgitation

they are blowing in character

[Music]

then the examiner and they asked you

about the different grades of number the

different grades of number there are

actually six degrees of Mama in grade

one the murmur is heard with extreme

difficulty in grid to the mammal is

easily audible but it's not out in

greatly mama is love without the trim in

grateful the mother is loud with her

three grade three without three great

for with three great fight it is love

article outset of record iam in grade

six it is audible even without status

quo the causes of pansystolic murmur

include MDV since morning

MTV channel like music ten mtv mitral

regurgitation and dr and beast the cost

of each section systolic ejection the

heart has to eject against a narrow

narrow passage this astronomer is

produced the heart has to eject against

a narrow passage like aortic stenosis

like pulmonary stenosis about the cost

of - turn numbers not usually asked from

the undergraduates but from the most

generous they may be asked so the dash

board members are further you are going

to bethe historic and Emily down story

the midde a solid positive attacks only

intrude on model stenosis tricuspid

stenosis whereas the cause of early

diastolic include the otic

reconsideration and regurgitation

then the examiner may ask you about the

other relevant questions which are

include which are pertinent into the

examination of the precordial like

in particular by reducing your patient

then for that you need to see whether

there are religions Oslo moves pretty

key bruises splinter hemorrhages also

you know baby the examiner may ask you

is your patient in heart failure or not

then you need to see whether the Ovation

have crabs in the chest or the

peripheral edema thank you so much