Etiology of Cardiovascular system

Written by Dr.Md.Redwanul Huq (Masum)
Saturday, 03 March 2012 05:58

Causes of abnormal pulses:

(Normal pulse is known as catacrotic pulse)

Regularly irregular pulse:

Atrial flutter

Single & unifocal ventricular extrasystole.

Irregularly irregular pulse:

Atrial fibrillation

Multiple & multifocal ventricular extrasystole.

Pulsus bisferiens (Double peak):

Here the pulse has slow upstroke & rapid downstroke.

-Found in aortic stenosis concomitant with aortic regurgitation.

Pulsus alternans (Alternating high & low volume pulse):

– Found in left ventricular failure.

Pulsus bigeminy:

Here a normal pulse is followed by an immature pulse due to extrasystole.

– Found in digitalis toxicity.

Collapsing pulse (high volume pulse):

Here the pulse has rapid upstroke & rapid down stroke with normal baseline.

Causes are-

1) Aortic regurgitation

2) Aortico- pulmonary fistula

3) Arterio venous fistula

4) Patent ductus- arteriosus

5) Thyrotoxicosis

6) Anemia

7) Fever

8) Beri-beri

9) Paget’s bone disease.

Anacrotic pulse (Low volume pulse):

Here the pulse has slow upstroke & normal down stroke.

– Found in aortic stenosis.

Pulsus paradoxus:

Here pulse volume increases with expiration & vice versa.

Causes are-

1) Constrictive pericarditis

2) Pericardial effusion

3) Severe acute bronchial asthma.

Pulsus deficit:

It is the difference between heart rate & pulse rate.

-Found in atrial fibrillation.

Causes of Atrial fibrillation:

1) IHD

2) Mitral valve disease

3) Hypertension

4) Thyrotoxicosis

5) Pulmonary embolism.

Causes of bradycardia:

Causes of bradicardia are-

Sinus bradycardia:

Physiological causes:

1) Athletes

2) Sleep.

Pathological cause:

1) Increased intracranial pressure

2) Obstructive jaundice

3) Hypothermia

4) Hypothyroidism

5) Drugs: e.g. Digoxin, Beta blockers, Verapamil.

Non-Sinus bradycardia:

2° & 3° Heart block.

Causes of cardiomegaly:

Causes of cardiomegaly are given below-

a) Dilated cardiomyopathy

b) Multiple valvular heart disease (except in only MS)

c) IHD

d) Congenital Heart diseases

e) Beri beri.

Causes of disproportionate tachycardia:

(Disproportionate tachycardia means heart rate is more in relation to body temperature)

Viral myocarditis.

Causes of epigastric pulsation

1) Lean & thin person

2) Aortic aneurysm

3) Tricuspid regurgitation

4) RVH.

Causes of impalpable apex beat:

1) Obesity

2) Position of the apex behind the rib

3) Pericardial effusion

4) Dextrocardia

5) Due to breast

6) Emphysema.

Causes of low-volume pulse:

1. Hypovolemia- due to diarrhea, vomiting

2. Left ventricular failure

3) Aortic stenosis

4) Mitral stenosis.

Causes of loud 1st heart sound:

a) Mitral stenosis

b) Hyper dynamic circulation

c) Tachycardia.

Causes of soft 1st heart sound:

a) Mitral regurgitation

b) Pericardial effusion

c) Calcified mitral valve.

Cause of MS:

Rheumatic fever.

Causes of raised JVP:

Non-pulsatile rise:

1) CCF (Congestive cardiac failure)

2) Constrictive pericarditis

3) Pericardial effusion

4) Superior venacaval (SVC) obstruction due to lymphoma or bronchogenic carcinoma

5) Cor-pulmonale.

Pulsatile rise:

1) Hypervolemia due to-

i) Physiological cause: Pregnancy

ii) Pathological causes:(These causes are also responsible for water hammer pulse, collapsing pulse or high volume pulse)

2) Aortic regurgitation

3) Aortico- pulmonary fistula

4) Arterio venous fistula

5) Patent ductus- arteriosus

6) Thyrotoxicosis

7) Anemia

8) Fever

8) Beri-beri

9) Paget’s bone disease.

Causes of relative bradycardia:

(i.e. Relative bradycardia means heart rate is less in relation to body temperature)

1) Typhoid fever

2) Dengue fever.

Causes of shifted apex beat:

1) Heart cause : LVH (Left ventricular hypertrophy)

2) Lung Causes:

a) Pushing the apex beat- massive pleural effusion or pneumothorax

b) Pulling the apex beat- Fibrosis or collapse of the lung.

Causes of Systolic murmur in tricuspid area:

a) TR

b) VSD

c) MR.

Causes of tachycardia:

Causes of tachycardia are-

Sinus tachycardia:

Physiological causes:

1) Pregnancy

2) Exercise

3) Emotion

4) Excitement.

Pathological causes:

1) Thyrotoxicosis

2) Fever

3) Anemia

4) Cardiac failure

5) Drugs, e.g. Adrenalin, Atropin.

Non- Sinus tachycardia:

Atrial flutter

Atrial fibrillation

Supra-ventricular tachycardia

Ventricular tachycardia.

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