Heart Murmurs Flashcards

1
Q

Crescendo-decrescendo murmur heard best at the right second intercostal space with radiation to the carotids

A

Aortic Stenosis

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2
Q

Holosystolic murmur heard best at the cardiac apex with radiation to the axilla

A

Mitral regurgitation

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3
Q

Midsystolic click + Holosystolic murmur heard best at the cardiac apex with radiation to the axilla

A

Mitral valve prolapse

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4
Q

Harsh holosystolic murmur at the left sternal border

A

Ventricular septal defect

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5
Q

“Decrescendo murmur at the right or left second intercostal space”

A

Aortic regurgitation

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6
Q

Opening snap with diastolic rumble heard best at the cardiac apex

A

Mitral stenosis

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7
Q

“plop with diastolic rumble”

A

Atrial Myoxma

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8
Q

“Continuous machine-like murmur”

A

patent ductus arteriosis

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9
Q

Wide FIXED splitting

A

atrial septal defect

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10
Q

Name two reasons for wide splitting

A
  1. pulmonary stenosis

2. Right bundle branch block

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11
Q

Name two reasons for paradoxical splitting

A
  1. Left bundle branch block

2. aortic stenosis

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12
Q

When does an S3 occur and why?

A

Right after S2. Due to volume excess

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13
Q

Name reasons for S3

A
Eccentric hypertrophy (back flow, dilated cardiomyopathy), RAAS over-activation (fluid overload)  
normal in children, athletes and pregnant women
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14
Q

When does an S4 occur and why?

A

It occurs right before S1 and represents pressure excess

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15
Q

Name reasons for S4

A

concentric hypertrophy, stiffening of LV wall,

chronically increased afterload due to hypertension, aortic stenosis, HOCM

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16
Q

Which maneuvers DECREASE preload? (2)

A

Valsalva, standing,

17
Q

Which maneuvers INCREASE preload? (2)

A

passive leg raise, squatting

18
Q

Which maneuvers INCREASE afterload?

A

handgrip, rapid squatting

19
Q

Name 7 causes of systolic mumurs

A
Aortic stenosis
Pulmonary stenosis
Mitral regurgitation
Tricuspid regurgitation,
VSD
HOCM
mitral valve prolapse
20
Q

Name 3 causes of diastolic murmurs?

A

aortic regurgitation
mitral stenosis
atrial myoxma

21
Q

What would happen to aortic stenosis murmur during standing?

A

Decrease in intensity due to decreased preload (less blood flow through stenotic vessel)

22
Q

What would happen to aortic stenosis murmur during handgrip?

A

Decrease in intensity because you have less flow (less turbulence) so quieter murmur

23
Q

What would happen to aortic stenosis murmur if you administered fluids

A

Increase in intensity because of increased preload

24
Q

What would happen to mitral regurgitation murmur if you raised your legs?

A

Increased intensity of the murmur because increased preload means more backflow

25
Q

What would happen to mitral regurgitation murmur during handgrip?

A

increase because increased afterload increases backflow

26
Q

What would happen to an aortic regurgitation murmur if you did Valsalva maneuver?

A

it would decrease in intensity because you are decreasing preload to the heart and thus decreasing backflow of blood

27
Q

What would happen to aortic regurgitation murmur if you squatted rapidly?

A

It would increase in intensity because more blood flowing backward from increased afterload

28
Q

What would happen to HOCM murmur if you were to stand?

A

it would INCREASE in intensity because you are decreasing preload (increased volume pushes l. hypertrophy out of the way to create less obstruction)

29
Q

What would happen to HOCM murmur during handgrip?

A

it would DECREASE because you’d have such little flow through that the murmur would become quieter.

30
Q

What would happen to mitral valve prolapse if you did handgrip maneuver?

A

it would increase intensity of murmur becuase increased afterload makes it preferential for fluid to flow backward, making mitral valve prolapse simialr to mitral regurgitation

31
Q

What would happen to mitral valve prolapse murmur if you gave nitrates?

A

it would INCREASE in intensity because of decreased preload the leaflets are more likely to prolapse