, • (hardening of ventricle (pressure) causes sound) - use BELL over APEX
- Physiologic: (hardly ever) 40-50 y/o after exercise.
- Pathologic: HTN, CAD, Cardiomyopathy, obstruction of blood (aortic stenosis and
ventricular hypertrophy)
- S4 occurs just before S1
Additional History: Infants, Children and Pregnant Women - ✔✔ANSW✔✔..Infants
• Maternal health: How was mother's health during pregnancy?
• Feeding pattern: Any cyanotic changes during nursing or crying?
• Growth and activity: Meeting developmental outcomes?
Children Growth and activity: Meeting developmental outcomes? Evidence of any chest
pain? History of respiratory infections Significant family history—genetic abnormalities
Pregnant women HTN during pregnancy? Associated clinical symptoms—proteinuria,
weight gain, edema? Experiencing faintness or dizziness?
Cardiac Cycle - ✔✔ANSW✔✔..Cardiac Cycle - Refers to filling and emptying of the
heart's chambers
Diastole (RELAXATION of the ventricles) - filling
Lasts 2/3 of the cycle
AV valves open, ventricles relax, blood rushes in
Rapid early filling (PROTODIASTOLIC)
Atria contracts (ATRIAL KICK) - last kick by the atria
Systole (CONTRACTION of the ventricles) - emptying
Lasts 1/3 of the cycle
Pressure in Vent > Atria
AV Valves close (S1)
Beginning of systole & all four valves are closed and ventricles contract
Higher pressure in ventricles and Aortic and Pulmonic valves open - Blood ejected
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