By Joseph G. Murphy, Margaret A. Lloyd
For busy clinicians, citizens, and fellows continuously challenged with a swiftly increasing physique of cardiology info, this expertly conceived 3rd variation of a best-selling textbook offers a modern succinct distillation of the present prestige of cardiovascular wisdom and ailment. From particular illnesses to specific symptoms, signs, and sufferer matters, together with being pregnant and middle illness and cardiac emergency, this simply readable textbook publications the reader via the entire crucial details required to skillfully procedure expert board examinations and perform cutting-edge medical sufferer care.
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Extra resources for Mayo Clinic Cardiology: Concise Textbook
Example text
Intensity of S2 Loud S2 Ordinarily, the intensity of the aortic component of the second heart sound (A2) exceeds that of the P2. The latter may occur in ASD (approximately 50% of patients). Hearing two components of the S2 at the apex is abnormal in adults, because ordinarily only A2 is heard at the apex. Thus, when both components of S2 are heard at the apex in adults, suspect ASD or pulmonary hypertension. Soft S2 Decreased intensity of A2 or P2, which may cause a single S2, reflects stiffening and decreased mobility of the aortic or pulmonary valve (aortic stenosis or pulmonary stenosis, respectively).
Innocent systolic murmurs usually are soft (≤grade 2 or less), are short, and have no associated abnormal clinical findings. In younger patients, an innocent systolic murmur often originates from the RV outflow tract or pulmonary artery. Remember that a patent ductus arteriosus or ventricular septal defect can masquerade as an innocent murmur. Diastolic Murmurs In general, the loudness of a diastolic murmur correlates with the severity of the underlying abnormality. ” This murmur is best heard with the patient in the sitting position, leaning forward, in held expiration.
9 Loud S1 Short PR interval Mitral stenosis Left atrial myxoma Hypercontractile states Soft S1 Long PR interval Depressed left ventricular function Early closure of mitral valve in acute severe aortic incompetence Ruptured mitral valve leaflet or chordae Left bundle branch block 10 ■ ■ Section I Fundamentals of Cardiovascular Disease A variable S1 intensity during a wide complex, regular tachycardia suggests atrioventricular dissociation and ventricular tachycardia. The marked delay of T1 in Ebstein anomaly is related to the late billowing effect of the deformed (saillike) anterior leaflet of the tricuspid valve as it closes in systole.