Murmurs

Question 1

Mitral stenosis- causes

Answer 1

Rheumatic heart disease

Infective endocarditis

Question 2

What can you hear in mitral stenosis and where?

Answer 2

Mitral region= 5th ICS midclavicular line 
Mid diastolic, 
low pitched murmur 
Loud S1 snap 
LUB—— dub —-shhhhhhh

Question 3

Signs of mitral stenosis

Answer 3

Malar flush = back pressure of blood into pulmonary system= rise in CO2 and vasodilation
Palpable apex beat
Atrial fibrillation

Question 4

Mitral regurgitation: causes

Answer 4

1. Idiopathic weakening of the valve with age
2. Ischaemic heart disease
3. Infective endocarditis
4. Rheumatic heart disease
5. CONNECTIVE TISSUE DISORDERS: Ehler danlos or Marfans

Question 5

Mitral regurgitation- what can be heard where?

Answer 5

S- mitral region 
C- whistling murmur 
R- radiating to left axilla
I- low intensity 
P- high pitched 
T- pan systolic

Question 6

Mitral regurgitation- what other signs can you get, what complication

Answer 6

Third heart sound LUB DE DUB

CONGESTIVE HEART FAILURE

Question 7

Aortic stenosis = causes

Answer 7

1. Idiopathic age related calcification

2. Rheumatic heart disease

Question 8

Aortic stenosis- describe the murmur

Answer 8

S- 2nd ICS right sterna border 
C- crescendo-decrescendo
R- carotids 
I- high intensity 
P- high pitched 
T- ejection-systolic

Question 9

Aortic stenosis- what other signs

Answer 9

• slow rising pulse

- narrow pulse pressure

Question 10

Aortic regurgitation- causes

Answer 10

1. Idiopathic age related weakness

2. Connective tissue disorders e.g. Ehlers Danlos or Marfans

Question 11

Aortic regurgitation - describe the murmur

Answer 11

S- 2nd ICS Right eternal border 
C- soft 
R- n/a 
I- low 
P- low 
T- early diastolic

Question 12

What other signs can you look for with aortic regurgitation?

Answer 12

1. Corrigan’s pulse
2. Water hammer sign
3. Quincke’s sign (visible pulsation on nailbed)
4. De Mussets sign
5. Austin Flint murmur