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S1, S2, S3, S4
- S1: loudest at apex, closing of AV valves
- S2: loudest at base, closing of semilunar valves
- S3: dec ventricular compliance ( CHF or valvular regurgitation), may be normal is people < 30 yo.
- S4: abnormal, heard on atrial systole if resistance to ventricular filling is present. - abnormal finding. Causes: cardiac hypertrophy, disease, injury to the ventricular wall
ICD vs Pacemakers
- - only for VT and VF
- - used when pacemaker fails
- 1. Measures pressure in the RA - Value: 3-8
- 2. Measures RAP and indirectly LAP - value: 4-12
- 3. MAP at least 60 for good perfusion
- 4. measures left vent end of diastole pressure: 6-12
Variant angina/ Prinzmetal angina
- 1. induced by exercise and relieve by rest or nitroglycerin
- 2. occurs at rest or lower level of activity, less predictable, often precursor to MI
- 3. prolonged and severe, occurs at the same time each day, most often at rest
What are some substances to avoid with anticoagulants?
- green leafy vegetables and food high in vitamin K
- Oral hypoglycemic
Anticote for heparin and coumadin
- Hep: protamine sulfate
- Coumadim - vitamin K