Bedside Cardiology Achyut Sarkar
INDEX
Page numbers followed by b refer to box, f refer to figure, t refer to table.
A
A wave
absent 97
prominent 97f, 98b, 307
Abdominovisceral situs 283
Abundant neck skin 54
Acrocyanosis 78
Acro-pectoral-renal-field defect 63
Acute aortic syndrome 31
Acute coronary syndrome 1, 29, 30
Airways 19
Alae nasi 42
Ambulatory blood pressure monitoring 134, 137
American College of Cardiology 136
American Heart Association 129, 136
Anacrotic notch 107f, 108
Anacrotic pulse 111, 112f, 113
Anatomically corrected malposition 299, 300f
Anemia 80, 188
Aneroid manometer 72
Angina 276
types of 29t
Angiotensin receptor blocker 39
Angiotensin-converting enzyme 39
Anomalous pulmonary venous connection, totally 332
Anoxia 47
Antianginal medications 32
Aorta 165, 295, 296, 301
ascending 79, 108, 300, 301b
crossover of 175
palpation, abdominal 125
Aortic aneurysm 24
abdominal 125
Aortic arch, right 320f
Aortic atresia 298
Aortic ball valve 208
Aortic bodies 17
Aortic click, mechanism of 198b
Aortic component 165, 216, 220, 221, 228, 230, 231
Aortic dilation
ascending 24
mild 51
Aortic dissection 55
Aortic distensibility 133
Aortic ejection 170
Aortic knuckle, dilated 338f
Aortic pressure 107, 197f, 255f
central 108, 255f
fall of 255f
transient rise of 255f
Aortic pulse, central 109
Aortic regurgitation 71, 112, 112f, 114f, 120, 121, 132, 181, 189, 213, 218, 228, 241f, 252, 317
acute 230
severe 169
mild 229
mild-to-moderate 236
moderate-to-severe 128
murmur 214, 229, 230f, 237
presence of 125
severe 169, 229
Aortic stenosis 112, 146, 181f, 182, 193, 213, 218, 218f, 252
severe 112f, 128
syndrome, supravalvular 58
to-and-fro murmur of 241f
Aortic valve
closure 113
opening 106, 145f
sclerosis 220
Aortic valvular click 197, 197f, 198
Aorticomitral discontinuity 297
Aortopulmonary collateral arteries 158, 317, 321f
Aortopulmonary window 241, 334
Apex
cardiogram 145f, 158f, 191
phonocardiogram 165f
Apical impulse 3, 142, 145, 146, 156, 308
abnormal 146
normal 145
palpation for 145
Arachnodactyly 51f
Arm
circumference 75f
pressure 130
Arrhythmia 25, 100, 133
Arterial blood gas 80
Arterial bruit 125
Arterial pressure 237
response, square wave 266f
Arterial pulsation 88f, 142, 152
Arterial pulse 106
wave 106
Arterial wall 108, 110
condition of 119
Arterioles, pulmonary 274
Artery
brachial 124f
hypertensive pulmonary 42
hypertrophied bronchial 276
Aspirin 39
Asplenia 284, 287
Atherosclerosis 142
multi-ethnic study of 36
Atresia 287
pulmonary 298, 320, 321f
Atrial contraction 233
Atrial depolarization 27
Atrial events 153
Atrial fibrillation 2, 14, 97, 98, 102f, 110, 133, 170, 179, 203f, 233f
postexercise 28
potentiation 217
scale, severity of 12
Atrial flutter 110
Atrial impulse 153
Atrial pressure, mean 191f
Atrial septal defect 23, 38, 41, 53, 140, 166, 178f, 179, 198, 205, 205f, 206f, 255f, 306, 331, 332, 334, 337, 338f, 339, 341
large 203
Atrial septum 24
Atrial situs 284
Atrial tachycardia, multifocal 110
Atriogenic valve 166
Atrioventricular alignment 289291, 291b, 291f, 292, 292f
Atrioventricular block 193
first degree 101f
Atrioventricular concordance 296f
Atrioventricular connection 287, 287b, 290
absence of
left 290f
right 290f
Atrioventricular discordance 295f
Atrioventricular dissociation 109
Atrioventricular hemodynamic, right 87
Atrioventricular nodal reentrant tachycardia 28
Atrioventricular pressure
gradient, higher 191f
pulse crossover 223f
Atrioventricular septal defect 332, 334
Atrioventricular valve
atresia
left 290f
right 290f
regurgitation 189
Atrium, identify right and left 285t
Auscultation 337
Auscultatory electronic manometer 72
Auscultatory gap 130
Austin Flint murmur 228, 235
Automated nonauscultatory electronic manometer 72
Autonomic dysfunction 138
Autopsy, sketch of 63
Autosomal dominant 55
Axillary artery aneurysm 85
Azygos veins, accessory 37
Azygos-hemiazygos venous system 37
B
Baby's muscles 54
Balloon-occlusion study 342
Bedside cardiology 1, 4b
Bell 69, 135
transmits 69
Bendopnea 24, 264, 265, 276
Beta blockers 39
Bicuspid aortic valve 198
Bilobed lungs, bilateral 284
Biochemical theory 115
Bioprosthesis 210
Bisferiens pulse 111
Biventricular impulses 152f
Bladder 74, 74f
central point of 75f
dimensions, acceptable 74t
length 75f
Bleeding parameters 48
Blood
flow, normal 212
pressure 45, 127, 130, 132, 133, 136, 137
auscultatory 133
diastolic 133
level of 133
measure 128b, 138
measurement 133, 135
pushes 164
rushes 213
volume of 87
Bone morphogenetic protein 335
Borg scale, modified 21, 21t
Brachial atrioventricular malformation 85
Bradyarrhythmia 109
causes of 110b
Bradycardia 203
presence of 134
Brain natriuretic peptide 188
Breast
euphemism for 68
hypoplastic 140
Breathing, difficult 42
Bronchial asthma, acute 118
Bronchial hyperemia, chronic 37
Bronchial mucosa 37
Bronchial veins 37
Bronchiectasis 42, 286
Brotmacher theory 46
Bulboventricular loop 294
C
Calf-leg pressure 133
Calibration 73
Canadian Cardiovascular Society 12
functional classification of angina pectoris 8, 9t
severity of atrial fibrillation scale 13b
system 6
Cannon wave 97
causes of 98b
regular 98, 102f
Capillary pulsation 121
Cardiac abnormalities 53, 55, 56, 58
incidence of 56
Cardiac anomalies, congenital 331
Cardiac auscultation 173
Cardiac catheterization 184, 342
Cardiac defect 51, 59, 61, 62
Cardiac disease 32
severity of 261
Cardiac drugs 39
Cardiac filing pressure 251
Cardiac hemodynamics 266
Cardiac index 34, 267
Cardiac malposition 282
Cardiac motion 190
theory 191f
Cardiac percussion 160
Cardiac position 282
Cardiac pulsation 141
Cardiac silhouette, square appearance of 329f
Cardiac syndrome 200
Cardiac tamponade 103, 117
Cardiohemic system 173
Cardiohepatic angle 162f
Cardiomyopathy
dilated 23
hypertrophic 146, 157, 157f, 193, 219
Cardiorenal rescue study 264
Cardiorenal syndrome 14, 267
Cardiovascular system 34, 212
cardinal symptoms in 17
Carditis 237
Carey Coombs murmur 228, 237
Carotid
artery 94, 123f, 215f
bodies 17
bruit 3
pulse 96f, 107
Catecholamine excess 28
Cellular intimal reaction 333
Central venous pressure 87
Chaotic atrial tachycardia 110
Chemoreceptors 18
Chest
in single ventricle, X-ray of 324f
in tricuspid atresia, X-ray of 329f
pain 1, 28
cardiac 28, 32
causes of 29t
score, emergency department assessment of 30
radiography 287
wall 142
anterior 240f
deformity 63
muscles 18
pain 31
posterior 240f
structures 19
X-ray of 309, 319, 323, 327
Cheyne-Stokes respiration 23
Chromosome 60
Chronic fatigue syndrome 34
Circular fasciculi 144f
Clubbed finger 82, 84f
Clubbing
congenital 85
grading of 82b
unilateral 85
Coarctation of aorta 122, 123f, 133
Cold extremity 265
Collagen fibers accompanies 133
Collapsing pulse 114b
Compression, abdominal 94
Concomitant cardiovascular disease 14
Congestion 262, 263, 267
hemodynamic 262
pulmonary 36, 41, 262
systemic 262
Conotruncal face 60b, 61f
Conus 298, 299f
Co-oximeter 80
Corneal arcus 142
Coronary arteriovenous fistula 242
continuous murmur of 242f
Coronary artery
anomalous left 306
disease 2, 29
pretest probability of 29t
Coronary sinus 285
Corpuscular hemoglobin, mean 81
Corpuscular volume, mean 81
Corrective cardiac surgery 331
Corrigan's sign 120
Cortical function 17
Cough 3739
cardiac causes of 39b
chronic 38
Counterclockwise depolarization 313f, 322f
Crescendo-Decrescendo
murmur 214, 248, 249
nature 215, 235
Crown-top baldness 142
Cuff 74
leg pressure, systolic 132
Cutis marmorata 78
Cyanosis 77, 77b, 78, 79, 79f, 85, 306f, 317
absence of 44
differential 307
onset of 305t
reverse differential 79, 307
Cyanotic burdens, grading 81t
Cyanotic heart disease 140, 157, 212, 304
cardinal symptoms in congenital 44
complex 304
congenital 77, 77b, 82, 104, 244, 245f, 303
D
de Musset's head 122
Death, causes of 341b
Deep vein thrombosis 31, 32
Dennison's sign 121
Deoxyribonucleic acid 61
Depolarization, clockwise 314f
Dextrocardia 282, 282f, 284, 286f, 293, 301
cardiac abnormalities in 283t
Dextrorotation 283
Dextroversion 283, 293
Diabetes mellitus 137
Diaphragm 69, 135
Diastolic augmentation 113
Diastolic pressure gradient 202f, 274
Dicrotic notch 108
Dicrotic pulse 111, 112
Dicrotic wave 108
Distal phalangeal depth 84f
Dizziness 27
Dock murmur 228, 232
Dorsalis pedis 131
Double-inlet ventricle 289, 289f
Down's syndrome 53, 53f, 54, 54t
Duke Activity Status Index 10, 11t
Duroziez's murmur 122
Dynamic auscultation 214, 251
role of 251
Dysplasia, acromelic 51
Dysplastic ear 54
Dysplastic pulmonary valve 182
Dyspnea 1, 17, 19, 27, 32, 41, 42, 263, 275
assessment of 20, 21
Borg scale of 21t
circuit of 17, 18f
feeling of 18
formal measurement of 20
mechanism of 18, 275
on effort 336
physiologic components of 17
severity scale of 20t
E
Ear
low set 64, 64f
normal 64f
Ebstein's anomaly 104, 159, 169, 307
Echocardiogram 303
Echocardiographic diastolic dysfunction 194
Echocardiography 266
Ectopia cordis 287
Edema 35, 82, 264
grading of 35, 35t, 36t
interstitial 42
Eisenmenger complex 46, 330, 332
Eisenmenger physiology 303, 304, 307, 330
Eisenmenger syndrome 38, 38b, 278, 330, 331, 337, 343
atrial septal defect 312f, 337
auscultatory features in 337b
clinical presentation of 336
diseases leading to 332
in large shunt, incidence of 331
natural history of 340
onset of 334t
patent ductus arteriosus 338
pathobiology of 334
pathophysiology of 333
physiology-wise diseases causing 332t
ventricular septal defect 337
Ejection click 171, 220, 308
Ejection murmur 218
Ejection sound 195
Ejection systolic murmur 215, 220, 318
causes of 216b
physiology 215
Elastic fibrils 333
Electrocardiogram 30, 191
Electronic manometer 72
Elevated jugular venous pressure 93b
Emphysema 24
infantile lobar 42
End-diastolic pressure 230
normal 94
raised 193
ventricular 188
Endocardial cushion defect 53
Endocarditis, infective 82
Endothelial dysfunction 334
End-systolic volume 103
Eosinophil 82
Epicanthic eye-fold 54
Erythrocytosis 48
Esophageal spasm 32
European Heart Rhythm Association 26
functional classification of atrial fibrillation 14
modified 14, 14t
European Society of Cardiology 136
European Society of Hypertension 136
Eustachian valve 24, 285
Exercise testing 266
Exertional dyspnea, mechanism of 276b
Extra-alveolar vessel resistance 117
F
Failure to thrive 42
Fatigue 34, 138, 265, 276
measure 34
mechanism of 34
signs of 34
symptom inventory 34
Feeding difficulty 42
Femoral artery, simultaneous palpation of 124f
Femoral bruit 3
Femoral pulse 109
Femoral venous return 94
Fibroblast 82
proliferation 82
Fibrous vascular occlusion, stage of progressive 333
First heart sound 164, 169, 171, 174, 192, 197t, 200, 214218, 220, 221, 223, 225, 226, 228, 230, 231, 233, 234, 253, 337
components of 164
factors determining intensity of 167b
loud 167b
soft 170b
Fistula
arteriovenous 127, 188
atrioventricular 85
pulmonary arteriovenous 243
Flat face 54
Flip-flopping, feeling of 27
Fluctuation test 82, 83f
Forceful impulse 149
Forearm pressure 131f
Fourth heart sound 171, 190194, 226, 253, 337
causes of 192b
Frequent ventricular premature beats 110
Frog sign 27
Frontoparietal baldness 142
G
Gallavardin phenomenon 218
Gallbladder disease 32
Gallop rhythm, systolic 200
Gallop sound 185, 187
Gastrointestinal diseases 32
Geneva Score for Pulmonary Embolism, revised 32t
Gerhardt's sign 121
Ghent diagnostic criteria, revised 52b
Giddiness 138
Goldman-specific activity scales 9t
determination of 9t
Graham Steell murmur 278
Great artery 281, 286
classical transposition of 326f
congenitally corrected transposition of 294, 325, 332
D-transposition of 159, 182
malposed 182, 297
nontransposed 328
normally related 297
spatial relations 299, 299b, 300f
transposition of 79, 160, 294, 297, 305, 306
Great vessel
complete transposition of 324
situs 284
Gross scoliosis, X-ray feature of 141f
H
Hall's criteria 54t
Hamman sign 207
Handgrip dynamometer 259f
Handheld echocardiogram 70f
Hang-out interval theory 178
Harsh murmur 213
Headache, coat-hanger 138
Heart 30
block, complete 101f, 127
boot-shaped 320f
classification of right-sided 282b
disease 7, 303
congenital 56, 305t, 306t, 331, 334
functional class, congenital 12, 12b
ischemic 23, 157
left 273b, 274
segmental approach in congenital 281
valvular 23
failure 15, 19, 20, 24, 34, 35, 262, 263t, 266f, 267, 268
acute decompensated 264
acute hypertensive 36
boston criteria of 268, 269t
clinical features of 262b
congestive 22, 29, 41, 94, 100, 263, 266, 307
diagnosis of 43
Framingham criteria of 268, 268f
functional classification of 14, 14t
grade of 269
index, pediatric 269, 270t
management of 262
mild 266
predictor of 1
right-sided 267
ross criteria of 268, 269, 269t
signs of 263t
symptoms of 263t
three symptoms of 24t
rate 237
score 30
sound 3, 95, 96f, 152, 308
surface anatomy of 161f
Hemiazygos connection 284
Hemiplegia 85
Hemithorax, right 282
Hemodynamic classification 273
Hemodynamic correlation 165, 186
Hemoglobin 78
Hemoptysis 37, 38b, 336
cardiac causes of 39b
Hepatic pulsation 120
Hepatic pulse 104
Hepatojugular reflex 93, 94, 225, 264
positive 264
Heterotaxy syndrome 284, 287
High amplitude 111
Hill's sign 2, 122, 132, 132t
Holt–Oram syndrome 57, 585f
Horse's left ventricle, level of 127
Hypercalcemia 59
idiopathic infantile 58
Hypercapnia 18
Hyperdynamic apical impulse 146
Hyperemia 37
Hyperkinetic impulse 146, 149
Hyperkinetic pulse 111
Hyperoxia test 80
Hyperplasia, vascular 82
Hypertelorism 63, 64f
ocular 64, 64f
Hypertension 59, 120, 136, 137t, 248
diastolic 134
exercise pulmonary 275
grade of 136
hyperkinetic pulmonary 241
isolated systolic 137
masked 137
precapillary pulmonary 273
supine 138
sustained 136
Hypertrophic obstructive cardiomyopathy 112, 112f, 122, 252, 253
murmur of 257f
Hypertrophy, biventricular 151
Hyperventilation 45
Hyperviscosity syndrome 47
grading 48t
symptoms of 48b
Hypokinetic apical impulse 146
Hypokinetic pulse 111
Hyponychial angle 83f
Hypoplasia 63
Hypotension
orthostatic 138
postprandial 138
Hypotonia, general 54
Hypoxemia 81, 82
Hypoxia 17, 18, 47, 273b
Hypoxic spell 44
I
Ileus, cirrhosis of 24
Immotile cilia syndrome 286
Immune status, abnormal 286
Imperceptible apical impulse 148b
Incident pressure pulse 108
Incisura 107, 175
Inflammatory bowel disease 82
Infundibular obstruction, development of 43
Innocent murmur 248
and sound 247, 248b
prevalence of 247
Inspiration 103, 195
Intensity 167, 183, 195, 213, 339
Interatrial septum, part of 24
Intercanthal distance, inner 64
Intercostal space 89, 279
Internal jugular pulsation 87
Interphalangeal depth 84f
Interpupillary distance 64
Intra-abdominal pressure 94
Intra-aortic balloon pump 113
Intra-arterial femoral artery pressure 133
Intra-arterial pressure 72
measurement 132
Intrathoracic pressure 87, 103, 117, 118
Iron binding capacity, total 81
Irregular cannon waves 98, 101, 101f
Irritant receptors 18
Ischemic pain, symptoms of acute 29t
Isometric handgrip 256
Isovolumetric contraction 197f
Ivemark syndrome 286
J
J-receptor 18
Jugular pulse pressure 315
Jugular venous pressure 2, 24, 87, 88, 92f, 93, 93f, 96, 105f, 263, 267, 337
mean 93
Jugular venous pulse 87, 95, 100, 102, 104, 204f, 276, 307, 317
Junctional rhythm 101, 102f
Juxtacapillary receptors 18
K
Kartagener syndrome 286
Kidney disease, chronic 137
Korotkoff sound 118, 128, 128b, 129, 130, 134, 135
mechanism of 129
Kussmaul's sign 103
L
Landolfi's sign 120
Left atrial
appendage 285
impulse 153
pressure gradient 117
Left atrium 223, 233, 234, 240, 242, 285
pressure curve of 165f
Left axis deviation 328f
Left bundle branch block 180, 181
Left lower sternal border 219
Left parasternal cardiogram 154f
Left ventricle 223, 230, 231, 233, 234, 240, 242, 295
double outlet 297, 298
pressure curve of 165f, 168f
Left ventricular
angiographic morphology 288f
apical impulse 160t
apical segment 150
dysfunction 3, 113, 189
end-diastolic pressure 41
enlargement 3, 147, 148b
hypertrophy 135, 147f
inflow obstruction, common causes of 235b
left atrial pressure 223
muscle 186f
outflow tract 181, 325
obstruction 324
pressure pulse 202
systole 143
volume overload 41
Leg
pressure 130, 131, 131f
raising, passive 259
Length-tension inappropriateness 19
Leopard syndrome 61
Lesion, common mixing 304b
Levocardia 286f, 301
isolated 287
Levoversion 293
Limbus, superior 285
Liver
cirrhosis of 24
midline 286f
Lovibond angle 83, 83f
Low pressure
chamber 113
tricuspid regurgitation 227b
Lower limb 133
pressure, measure 131
pulsations, absent 307
saturation 47
Luetic aorta 229
Lung 19
carcinoma 82
disease 273b
hypothesis 19
parenchyma 42
Lutembacher's syndrome 233
Lymphatic system 22
Lymphocytes 82
M
Mammary soufflé 245
Marfan syndrome 50, 50f, 51f, 52, 52b, 140
inheritance 50
Maxillary molar teeth 66f
Means–Lerman sign 207
Mechanical alternans 115
Mechanical theory 115
Mechanoreceptors 17, 18
Mediastinal crunch 207
Medullary center 17
Mercury manometer 71, 73f
Mesocardia 287
Metacarpal index 51f
Methemoglobinemia 78
Midsystolic click 200
Midsystolic murmur, physiology of 217f
Minervini's sign 120
Mitochondrial oxidative phosphorylation 20
Mitral ball valve 210
Mitral leaflets 164
posterior 169
Mitral opening snap 202, 204t
causes of 204b
Mitral regurgitation 51, 71, 177, 182, 203, 213, 223, 226, 252, 278
acute 38, 193f, 226
chronic severe 226
congenital 224b
functional 227
ischemic 227
murmur 218, 224
physiology of 223f
severe 154f, 177
systolic murmur of 252
Mitral stenosis 23, 37, 156, 156f, 168, 168f, 188, 194, 204b, 205, 205t, 206f, 213, 228, 232, 233f, 257, 278
cases of 233
dominant 156
murmur 3, 214, 237
severity of 202, 202f, 232, 234f
silent 234
Mitral valve 51, 166, 168f
closure 165f, 169, 169f, 171
opening 202
premature 185
prolapse 51, 140, 168, 169, 200, 201, 227, 253, 254, 258f
nonejection click of 200f
syndrome 168
Modern cardiology 104
Monosomy X 53
Morris sign 162f
Motor cortex 17
Motor innervation 68
Mucous membrane 77
Muller's maneuver 256
Muller's sign 120
Multifactorial mechanism 331
Murmur 3, 212, 213, 224, 228, 309
causes of continuous 245f
classification of continuous 240t
continuous 239, 243f, 244, 254, 309
decrescendo diastolic 241f
determinant of 213
diamond-shaped 214
midsystolic 241f
diastolic 3, 129, 134, 140, 210, 228, 228b, 229, 232, 249, 260, 309
flow 225
different
diastolic 228f
shapes of 214f
systolic 216f
early
diastolic 228
systolic 215, 226
features of innocent 248b
functional 248
grade of 222
hemodynamic classification of continuous 239b
high-frequency 240
intensity of mid-diastolic 233
late systolic 215, 227
late-crescendo 243
Levine grading system of systolic 214b
loud 155, 228
mid-diastolic 278
mid-late systolic 219
mid-systolic 215
mitral diastolic flow 241
pansystolic 215, 223
presystolic 233
pulmonary branch 249
shape of 222
supraclavicular 249, 249f
systolic 200, 207, 213, 215, 239, 309
timing of 215f
Muscle hypothesis 19
Muscularization, stage of 333
Myopia 51
N
Nail fold 83
Narrow physiological splitting 182, 182b
Natriuretic peptide 266
brain-type 340
Neck
short 65
veins 336
Negative predictive value 263
New York Heart Association 6, 10, 12, 14
classification 12b
system, uniqueness of 8
functional classification 6, 7t
limitation of 8
Nocturnal dyspnea, paroxysmal 1, 22
Nonejection click, causes of 201b
Nonejection sound 200
Noonan syndrome 55, 56, 56f
diagnostic criteria for 57b
Norepinephrine blood levels 266
Normotension, true 136
O
O'Donnell theory 47
Obstruction, severe 219
Obstructive pulmonary disease
acute exacerbation of chronic 118
chronic 1
Opening snap 202, 205, 233, 234
Operability and pulmonary vascular resistance 342
Orthodema 264
score 264t
Orthopnea 21, 22, 263
Orthostasis 265
Oscillometric manometer 72
Osler's sign 134
Outer intercanthal distance 64
Oximeter 77
Oxygen
consumption 45
saturation 81
P
Packed-cell volume 81
Pain
esophageal 32
pericardial 30
Palate
height 66f
high-arched 66
width 66f
Palfrey's sign 121, 121f
Palmar arch aneurysm 85
Palpation 142, 276, 308, 337
abdominal 125
tool 142
Palpitation 2, 25, 27, 28
causes of 25
clinical
classification of 26b
evaluation 27
types of 26
etiological classification of 25t
etiology 25
pathophysiology 25
Pancreatitis 32
Pansystolic prolapse 169f
Parasternal impulse 148
grading 150b
Parasympathetic pathway 25
Parenteral vasoconstrictor 260
Paroxysmal hypoxic spell 44
Patent ductus arteriosus 127, 181, 239, 254, 305, 306, 332, 334, 337, 338f, 340, 341
continuous murmur of 241f
Patent foramen ovale 23, 305, 307
Paul Wood's series 332t
Peak systolic arterial pressure 134
Pectus
carinatum 50f, 140, 141f
excavatum 50f, 141f
Peptic ulcer disease 32
Percussion
method 160
wave 107, 111
Perfusion 262
Pericardial constriction 103
Pericardial disease 102
Pericardial effusion 23f, 162, 162f, 163
Pericardial knock 103f, 155f, 206
Pericardial rub 207
Pericardial sound 206
Pericarditis
adhesive 201
constrictive 94, 103f, 155, 155f, 207
Pericardium, part of 30
Peripheral artery, major 258
Peripheral sign 120
Peripheral transmission 108, 108f
Phalangeal depth ratio 84, 84f
Phenotype 51, 53, 55, 5759, 6163
Physiological zero point 89
Physiology
common mixing 303, 304
transposition 303
Pivotal dextrocardia 283
Platypnea-orthodeoxia syndrome 23
Plexiform lesion 333
Plexogenic arteriopathy 333
Pneumectomy 24
Pneumonia 42
Pneumothorax, left-sided 201
Poland syndrome 62
Polycythemia 82
Polysplenia 284, 286, 287
syndrome 286
Polyuria 28
Popliteal artery 124f
pulse 124f
Popliteal fossa 124f
Positive predictive value 263
Precordial impulse 154f
Precordium 140, 315
Pregnancy 188
Premature beat 259
Premature closure theory 186f
Premature ovarian failure 56
Pressure
difference 133
overload 192
volume
relation 190
theory 191f
Presyncope 27
Pretricuspid and post-tricuspid shunt 334
Proinflammatory cytokines 20
Prosthetic valve 208
different 209f
types of 208b
Provocative dyspnea assessment scale 20, 21b
Proximal aortic pulse 107, 107f
Pseudocyanosis 78
Pseudoejection sound 201
Pseudohypertension 134
Pulmonary and aortic diastolic pressures 342
Pulmonary arterial hypertension 12, 12b, 38, 273, 273b, 274, 330, 331, 333b, 335b, 341
hyperkinetic 341
irreversibility of 341t
obstructive 341
pathobiology for 335f
with small defects 331
Pulmonary arterial pressure 279
mean 274
Pulmonary arterial pulsation 152
Pulmonary arterial wall 333
Pulmonary arteriopathy, pulmonary 333, 333b
Pulmonary artery 79, 177, 179, 197, 222, 231, 240242, 242f, 244, 295, 296, 305, 306, 338f
catheterization effectiveness 1, 22, 263
dilated right 338f
distension of 38
ipsilateral main 286
left 42, 284
left and anterior to 301b
lower 196f
pressure 2
systolic 3
right 42
stenosis, peripheral 222
Pulmonary capillary wedge pressure 1, 22, 273, 274
tracing 154f
Pulmonary circulation 303
Pulmonary component 216, 220, 221, 228, 230, 231, 328
Pulmonary edema, acute 23
Pulmonary ejection
click 277
murmur 277
Pulmonary embolism 31, 32
well model for 31t
Pulmonary hypertension 3, 15, 43, 156, 180, 203, 232, 272, 273b, 274, 276b, 279, 330, 331, 334
auscultatory features of 277b
borderline 275
clinical
classification of 272, 272b
grading of 279, 279t
pattern 274
postcapillary 273, 274
primary 272
Pulmonary interstitial space 41
Pulmonary outflow
resistance, total 315
tract, transposed 323
Pulmonary overcirculation 41
Pulmonary regurgitation 228, 231, 277
murmur of 231f
normal pressure 232
severe 317
Pulmonary stenosis 160, 182, 195, 198, 213, 220, 220f, 221, 221f, 252, 287, 305, 316, 322, 322f, 323, 325, 326f, 327, 328f, 329f
mild 195
severe 158, 196
Pulmonary stretch receptors, stimulation of 18
Pulmonary valve 196, 279, 285, 294
absent 182
aortic to 296
syndrome 232
Pulmonary valvular
click 195197, 199, 277t
disease 274, 331, 333
ejection click 196f
resistance 42, 45, 274, 315, 330, 343, 343t
stenosis 177, 322
Pulmonary vascularity, reduced 320f
Pulmonary venous system 177
Pulmonary ventricle decompresses 303
Pulsation and obstruction scale 109b
Pulse 2, 110, 120, 122, 307, 336
double-beating 111, 112f
origin of 106
oximeter 80
peripheral 108
pressure 108, 111, 114f, 122, 127, 230f
normal 111
proportional 128, 265
wave contour 108
Pulsus
alternans 115
causes of 115b
bigeminy 109
bisferiens 112f, 114
magnus 120
paradoxus 116, 116b, 118
amount of 118
reverse 119, 119b
parvus et tardus 113
Pump failure 3
Q
Quincke's sign 121
R
Radial arteries, simultaneous palpation of 124f
Radial pulse 109
Radionuclide ventriculography 266
Recoil theory 143
Recumbent posture, squatting in 46
Red blood cell 47
Reflective wave augments 108
Reflux, abdominojugular 93
Regurgitant systolic murmur 215, 222
characteristic 223
physiology 222
Regurgitation, hypertensive pulmonary 231
Renal disease, end-stage 14
Renal failure, chronic 207, 228, 237
Renal insufficiency 248
Renal replacement therapy 14
Respiration 260
effect of 90
on pulse volume 116
Respiratory center 23
Respiratory discomfort, sensation of 19
Respiratory muscle 17
activity 18
Respiratory pressure 19
Respiratory symptoms 43
Respiratory tract infection 43
Respiratory variation 195
Rheumatic fever, acute 237
Right and left atrium, morphology of 285f
Right atrial
appendage 285
impulse 153
pressure 95, 103, 267
curves 97f
Right atrium 103, 240, 242, 285
center of 91f
contracts 96
prominent 329
Right axis deviation 322f
Right bundle branch block 166, 176, 177
Right ventricle 231, 240, 242, 295
double outlet 160, 298, 303, 322, 332
forming apex 151f
Right ventricular
angiographic morphology 288f
apical impulse 160t
cavity 143f
dysfunction, severe 180
end-diastolic pressure 195, 196f
hypertrophy 314f, 320, 322f
impulse 148
abnormal 149
normal 148
inflow obstruction, common causes of 235b
obstruction 45
outflow tract 28, 318
pressure curves 97f
systole 94
Rosenbach's sign 120
Rotch sign 162f
Rule of thumb 250
Rytand murmur 228, 237
S
Schamroth's sign 84, 84f
Schizophrenia 61
Second heart sound 144, 165, 171, 173, 174, 177b, 191, 193, 214218, 221, 223, 225, 226, 228, 230, 233, 234, 256, 278, 318, 337, 339
production, mechanism of 173
single 182b
wide splitting of 177b
Semilunar valves 173
Sensory cortex 17
Serum ferritin 81
Serum transferrin 81
Sex distribution 336
Shock, septic 113
Short stature 55
Shoulder pain 138
SHOX gene 54
Shunt
bidirectional 330
cardinal symptoms in left-to-right 41
left-to-right 42, 43, 189, 330, 331
lesion 77, 343t
congenital 330
prevalent systemic-to-pulmonary 331
right-to-left 24
Simplified Emergency Department Assessment of Chest Pain Score 30
Single arterial trunk 298
Single inlet ventricle 290f
Sinus
ambiguous 286
bradycardia 127, 266
Sinus of Valsalva, ruptured 243, 243f
Sinus tachycardia 110, 266
inappropriate 28
mild 187
Sinusitis, chronic 286
Situs 283
ambiguous 282, 286f
inversus 282, 285, 286f, 293, 295f, 296f, 301
solitus 282, 284, 293, 301
D-loop with 294
Six-minute walk test 15
Skeletal muscle 19
Skin
bluish 78
discoloration of 77
Sleep 28
Slows down pulse wave 113
Small amplitude pulse 113
Small pulmonary arteries 333
Smaller ring finger 58f
Snowman sign 311f
Specific activity scale 10
Sphygmomanometer 71
auscultatory 256
Sphygmomanometric artifact 2
Sphygmomanometric pressure 134
Spiral fibers 147f
Splenic nodules, two 286f
Splitting 339
grading of 339b
reverse 180, 181b
Squatting 45, 336
diseases associated with 46
Stable angina 28
Stenosis, severe 221f, 234
Stethoscope 68
acoustic 69
advantage of 140
diaphragm of 125
digital 70
electronic 70
ideal 69
modern 68
ultrasound 70
Stiff skin syndrome 51
Stiffness, vascular 134
Still's murmur 247
Stomach 286f
Straight back syndrome 140, 141f, 248
Stroke 213
index 34
Subclavian artery, right 62
Subxiphoid palpation 192
Summation gallop 187
Supraclavicular fossa 249f
Supravalvular stenosis 219
Supraventricular tachycardia, paroxysmal 110
Sympathetic nervous system 256
Sympathetic pathway 25
Synchrony 120, 130
Syncope 27, 276
Systemic arterial pressure 46
Systemic vascular resistance 315, 342
Systemic venous congestion 267
Systolic fall 98
Systolic murmur, types of 215b
Systolic pressure 108, 118, 127, 135, 256
Systolic wave 108
rest of 107f
Systolo-diastolic murmur 244
T
Tabatznik's syndrome 57
Tachyarrhythmia 110, 115
causes of 110b
Tachycardia 28
re-entry 27
ventricular 101, 110
Tachypnea 41
Tamponade, presence of 116
Telecanthus 63, 64, 64f
Tension 19
Tetralogy of Fallot 53, 157, 158f, 198, 198b, 221, 307, 316, 317, 319f, 336
X-ray in typical 320f
Tetralogy physiology 303, 304, 315, 316
extremely severe 317
mild 316
moderate 316
severe 317
under umbrella of 317
Third heart sound 185, 187, 188, 193, 204t, 225, 226, 337
ventricular theory of 186f
Thoracic aorta 125
Thoracic structural deformity 140
Thoracovisceral situs 284
Thumb sign 50f
Thyrotoxicosis 188
Tibial artery, posterior 131
Tidal wave 108
Tilting-disk valve 210
Tissue oxygenation 48
To-and-fro murmur 244
causes of 244b
Total anomalous pulmonary venous 286
connection 305, 306
Snowman sign of 311f
drainage 332
Tracheal tug 152
Tracheobronchial situs 284f
Tracheobronchial tree 37
Transcatheter aortic prosthetic valve, different 211f
Transient arterial occlusion 258
Transpulmonary pressure gradient 274
Traube's sign 121
Trepopnea 23
Tricuspid annular plane systolic excursion 340
Tricuspid atresia 158, 327, 328f
Tricuspid opening snap 203, 204f
Tricuspid regurgitation 71, 155, 156, 224, 253, 276, 337, 341
murmur 71, 224, 259, 277
primary 227
severe 99f, 141, 155, 204f
Tricuspid stenosis 169, 213, 228, 235
Tricuspid valve 24, 98
closure 169, 171
disease 94
Trigeminal nerve modulate dyspnea 18
Trilogy of Fallot's 158
Triple apical impulse-presystolic wave 157f
Trisomy 21 53
Truncus arteriosus 160, 182, 312f
Turner's syndrome 53, 54, 55f, 140
diagnostic criteria for 56b
phenotype of 54
U
Upper arm veins 104
Upper lobe bronchus, carcinoma right 85
Upper-to-lower segment ratio 65
Urate metabolism 48
V
V wave, abnormal 99
Valsalva
effect of 255f
maneuver 255, 256, 266, 266f
Valve 208
ventriculogenic 166
Van Praagh classification double inlet ventricle 289b
Vasodilator 260
testing, acute 342
Veins 87
bronchopulmonary 37
pulmonary 117
systemic 37
Velo-cardio-facial syndrome 59
Vena cava
inferior 24, 79, 283, 285
superior 47, 242, 285, 295
Vena caval connection 160
Venous pressure 98
normal 89
Venous pulsation 88, 88t, 102f
Venous pulse 104
abnormal 96
normal 94
Venous tone 87
Ventricular dysfunction 27, 188
Ventricular filling pressure 263
Ventricular loop 293f
Ventricular premature beat 38
Ventricular septal defect 44, 53, 104, 140, 160, 177, 182, 221, 221f, 222, 225, 225f, 241, 252, 288, 303, 305, 315, 320, 321f, 322, 322f, 326f, 328f, 329f, 332, 334, 337, 338f, 339, 341
murmur of 241f
Ventriculoarterial connection 294, 296b, 297b, 298f
normal 294
Ventriculoarterial junction 281
Venturi effect 112
Vertigo 138
Vision, blurring of 138
Visual analog scale 21, 22f
Vortex shedding 212
W
Water hammer
pulse 114
theory 129
Weight gain 35, 36
Weill-Marchesani syndrome 51
Wheeze, pulmonary 265
White coat
hypertension 137
reverse 137
Wide fixed splitting 177
Williams syndrome, diagnostic criteria for 60t
Williams–Beuren syndrome 58, 59f
Wolff–Parkinson–White syndrome 176, 177
World Health Organization 12, 340
classification 12b
X
X descent
abnormal 98
reduced 99b
systolic 94
X monosomy
complete 56
partial 56
Xanthelasmata 142
X-chromosomal materials 54
Y
Y descent
abnormal 99
prominent 100b
Yellow sputum 39
Z
Z-score 52
×
Chapter Notes

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