Exam (elaborations)
ALU 301 AN UNDERWRITER-S GUIDE TO CARDIAC DIAGNOSTIC TESTING
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ALU 301 AN UNDERWRITER-S GUIDE TO CARDIAC DIAGNOSTIC TESTING
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Auscultation with the stethoscope. By listening for the timing and intensity of heart
sounds, the physician can detect the various murmurs associated with heart disease.
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Most valuable element of the physical exam?
,Left main artery (would need immediate bypass), which leads to the left anterior
descending and left circumflex arteries. The right coronary artery.
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Major coronary arteries?
1. Normal - >50%
2. Mild impairment - between 45% to 50%
3. Moderate impairment - between 40% and 45%
4. Severe impairment - <40%
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Ejection Fraction values
Grade 1: Barely audible with utmost concentration
Grade 2: Soft, but easily heard
Grade 3: Loud without thrill
Grade 4: Loud with thrill
Grade 5: Loud, heard with barely any contact between stethoscope and chest wall
Grade 6: Loud, heard with stethoscope off the chest wall
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Murmur grades
, Found mostly in skeletal muscle (CPK-3)
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CPK-MM
Uses ultrasonic, high frequency impulses to visualize the structure and function of the
heart and great vessels. It is a generally accurate, inexpensive and noninvasive test.
Good for pericarditis or effusion.
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Echocardiography
A superficial, high-pitched, or scratchy sound that is diagnostic of pericarditis.
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Pericardial friction rub
Concentrated in the brain and lungs (CPK-1)
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CPK-BB
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