heart murmur descriptions Flashcards
Mitral regurgitation
Loud pansystolic murmur at the apex radiating into the axilla. Best heard in the left lateral position.
- displaced apex beat with thrusting.
- may be systolic thrill over apex.
- soft S1
Mitral valve prolapse (Barlow Syndrome)
Mid-systolic click, followed by a late systolic murmur heard best at the apex. Squatting delays the click, standing increases the murmur.
Mitral Stenosis
Rumbling mid-diastolic murmur heard at the apex and radiationg to the axilla. heard best in in the left lateral position - accentuated by excercise
- Tapping undisplaced apex beat
- Loud S1 and S2
- Left parasternal heave
Aortic regurgitation
High pitched early diastolic murmur audible in the aortic area and at the left sternal edge. Best heard leaning forward on end expiration
- Wide pulse pressure which is collapsing
- Apex beat is thrusting and displaced to 6th intercostal space in the anterior axillary line (volume overload)
Aortic stenosis
Harsh ejection systolic murmur heard best at the left sternal edge (2nd ICS) . loudest leaning forward on end expiration and may radiate to carotids.
- Narrow pulse pressure and slow rising pulse
- aortic thrill
- Apex is forceful but usually undisplaced
Tricuspid regurgitation
Pansystolic murmur heard loudest at lower left sternal edge during inspiration
- AF common
- JVP raised with giant v waves
- Tender pulsatile hepatomegaly
Mechanical mitral valve replacement
Click on first heart sound (closure of valve)
Possible mid-diastolic murmur (more common with old ball-and-cage valve)
Pansystolic murmur? (leaking of prosthetic valve)
Mechanical aortic valve replacement
Normal first heart sound
Ejection click (opening of prosthetic valve)
Soft ejection systolic murmur
Click on second heart sound (closing of valve)
Early diastolic murmur? (leaking - also wide pulse pressure and collapsing pulse)
