Murmurs Flashcards

1
Q

Bedside maneuver: inspiration

A
  • increases intensity of right heart sounds
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2
Q

Bedside maneuver: expiration

A
  • increases intensity of left heart sounds
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3
Q

Bedside maneuver: hand grip (increased systemic vascular resistance)

A
  • increases intensity of MR, AR, VSD, MVP

- decreases intensity of AS, hypertrophic cardiomyopathy murmurs

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4
Q

Bedside maneuver: valsalva (decreased venous return)

A
  • decreases intensity of most murmurs

- increases intensity of MVP, hypertrophic cardiomyopathy murmurs

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5
Q

Bedside maneuver: rapid squatting (increased venous return, increased preload, increased afterload with prolonged squatting)

A
  • decreases intensity of MVP, hypertrophic cardiomyopathy murmurs
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6
Q

Description of MR

A
  • holosystolic, high-pitched “blowing murmur” that radiates towards axilla
  • systolic murmur
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7
Q

Maneuvers that can increase intensity of MR

A
  • increased TPR (squatting) or LA return (expiration)
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8
Q

Description of TR

A
  • holosystolic, high pitched murmur that radiates towards right sternal border
  • systolic murmur
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9
Q

Maneuvers that can increase intensity of TR

A
  • increased RA return (inspiration)
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10
Q

Description of AS

A
  • crescendo-decrescendo systolic murmur following ejection click
  • radiates towards carotids/heart base
  • systolic murmur
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11
Q

Description of VSD

A
  • holosystolic, harsh-sounding murmur
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12
Q

Maneuvers that increase VSD

A
  • hand grip due to increased afterload

- systolic murmur

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13
Q

Description of MVP

A
  • late systolic crescendo murmur with midsystolic click
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14
Q

Maneuvers that increase MVP

A
  • decreased venous return (standing or Valsalva)

- systolic murmur

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15
Q

Description of AR

A
  • high pitched “blowing” decrescendo murmur
  • bounding pulses, and head bobbing
  • diastolic murmur
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16
Q

Maneuvers that increase or decrease AR

A
  • increase: hand grip

- decrease: vasodilators

17
Q

Description of MS

A
  • follows opening snap
  • delayed rumbling
  • best heard in left lateral decubitus
  • diastolic murmur
18
Q

Description of PDA

A
  • continuous machine-like murmur
19
Q

Description of normal splitting

A
  • delayed closure of pulmonic valve during inspiration
20
Q

Description of wide splitting

A
  • delayed closure of pulmonic valve regardless of breath

- an exaggeration of normal splitting

21
Q

Conditions that can cause wide splitting

A
  • any condition that delays RV emptying such as pulmonic stenosis or RBBB
22
Q

Description of fixed splitting

A
  • pulmonic closure is greatly delayed
23
Q

Conditions that can cause fixed splitting

A
  • ASD (left to right shunt)
24
Q

Description of paradoxical splitting

A
  • P2 sound occurs before delayed A2 sound
25
Q

Conditions that can cause paradoxical splitting

A
  • any condition that delays LV emptying such as aortic stenosis or LBBB