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Cardiac Auscultation Practice - S3 Gallop

S3: add this extra heart sound by tapping second finger twice

Setup:
Auscultation Practice - S3 ... Gallop S3: add ... ptfaddenMD #S3 ... #Gallop #HeartSounds ... PhysicalExam #Clinical #Video
Cardiac Auscultation Practice - S4 Gallop

S4: add this extra heart sounds by tapping first finger twice

Setup:
Practice - S4 Gallop ... ptfaddenMD #S3 ... #Gallop #HeartSounds ... PhysicalExam #Clinical #Video
HFrEF - Low Ejection Fraction on Physical Exam - Likelihood Ratios
 - Displaced Apical Impulse
 -
Respirations - S3 ... Gallop - Normal
Myocarditis
Diagnosis 
• Endomyocardial biopsy (gold standard, rarely performed) 
• Clinical presentation 
• Cardiovascular MRI 
Clinical 
•
tachycardia • S3 ... S4 or summation gallop
Apical Impulse Waveforms on Physical Examination
- Normal
- Sustained Palpable S4
- "Triple Ripple"
- Palpable S3

#Apical #Impulse #Waveforms
Ripple" - Palpable S3
PECARN - Pediatric Head Injury Decision Aid - Mayo Clinic
PDF: https://s3-us-west-2.amazonaws.com/creatorphotos.clacdm.com/diagrams/PECARN%20DA.pdf

#Management #PatientInfo #Peds #Pediatrics #DecisionAid #PECARN
Clinic PDF: https://s3
Double Apical Impulse (S4) Visualization on Physical Exam - Hi-Res Video Version: https://www.grepmed.com/images/7802/physicalexam-cardiology-impulse-double-gallop-apical-signs

On palpation, the PMI
Exam - Hi-Res Video ... physicalexam-cardiology-impulse-double-gallop-apical-signs ... #Impulse #S4 #Gallop ... #PhysicalExam #Video
Shock - Differential Diagnosis Framework
MAP = CO x SVR
Hypovolemic (↓ Intravascular volume):
 • Hemorrhage, dehydration due
pulse pressure, pallor ... pulse pressure, S3
Acute Heart Failure Exacerbation - Diagnostic Likelihood Ratios
+LR > 3.5:
 • Overall judgement of ED physician
failure • JVD • S3
Heart failure with Reduced Ejection Fraction (HFrEF)
Clinical Presentation
1. Typical symptoms: dyspnea, orthopnea paroxysmal noctumal dyspnea, fatigue,
abdominojugular, reflux s3 ... (gallop rhythm)