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BT_Step1_NTK > Cardiac Mummurs/Pathophys > Flashcards

Cardiac Mummurs/Pathophys Flashcards

1
Q

What murmur is hear in mitral stenosis?

A

OS followed by mid-late-DISASTOLIC rumbling

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2
Q

Systolic murmurs: (4)

A
  1. Aortic/Pulmonic Stenosis
  2. Mitral/Tricuspid Regurgitation
  3. Mitral Valve Prolapse
  4. Ventricular Septal Defect
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3
Q

Diastolic murmurs: (2)

A
  1. Aortic/Pulmonic Regurgitation

2. Mitral/Tricuspid Stenosis

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4
Q

What type of murmur is a mitral valve prolapse?

A

Systolic

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5
Q

What is the murmur head with mitral prolapse?

A

systolic murmur with mid-systolic click; d/t excess valvular tissue prolapsing from Left atrium.

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6
Q

Clinical signs commonly associated with aortic regurgitation: (3)

A
  1. Head bobbing
  2. Pulsating nail bed (d/t widened pulse pressure)
  3. Water hammer pulse (d/t widened pulse pressure)
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7
Q

______ regurgitation is an early, high pitched “blowing” diastolic murmur.

A

Aortic regurgitation

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8
Q

3 causes of aortic stenosis?

A
  1. cong. bicuspid aortic valve (pt. <30 years)
  2. degenerative age-related calcified aortic valve (pt. >60)
  3. chronic rheumatic fever
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9
Q

In a sexually active Pt. a high pitched, blowing diastolic murmur suggests what valvular issue?

A

aortic regurg; ==> soft, tumor-like growths concerning for gummas in tertiary phase of syphillis.

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10
Q

_______ regurgitation: holosystolic high pitched “blowing” murmur, heard loudest at the apex, radiates to the axilla.

A

Mitral regurg.

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11
Q

what murmur presents as a holosystolic high pitched “blowing” murmur, heard loudest at the apex, radiates to the axilla.

A

Mitral regurgitation

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12
Q

what cardiac valvular issue can lead to left-atrial dilation and hypertrophy which compresses the esophagus and lead to dysphagia for solids?

A

Mitral stenosis

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13
Q

What cardiac valvular issue leads to increase in systolic pressure leads to an increased pulse pressure?

A

Aortic Regurgitation. ejected blood from the aorta back to the L.V. during diastole. this decrease peripheral arterial diastolic pressure leading to a increase LVEDV, which increases SV.

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14
Q

“Pulsus parvus et tardus”: pulses are weak and late compared to heart beat due to outflow obstruction secondary to a stenotic _____ valve

A

aortic valve

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15
Q

A prior MI is concerning for (what murmur?) with papillary muscle dysfunction

A

mitral regurgitation

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16
Q

Exertional dyspnea, angina, syncope, and a congenital bicuspid valve usually point to what valvular issue?

A

aortic stenosis

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17
Q

Tertiary syphilis is associated with (what murmur?) Patients may also present with “gummas,” or, soft tumors on his or her hands and elbows.

A

aortic regurgitation

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18
Q

What murmur is almost always secondary due to rheumatic heart disease?

A

Mitral stenosis; typically presents with signs of pulmonary congestion, rather than angina.

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19
Q

what murmur typically presents with signs of pulmonary congestion, rather than angina?

A

Mitral stenosis

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20
Q

Mitral valve prolapse associated with genetic disorders (5)

A
  1. Marfan’s syndrome
  2. Ehlers-Danlos syndrome
  3. ADPKD
  4. Fragile X syndrome
  5. Klinefelter syndrome
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21
Q

That is the classic triad S/Sx of aortic stenosis?

A
  1. Syncope (decreased blood flow to brain).
  2. Angina (decreased blood flow through coronary arteries in diastole).
  3. Dyspnea.
22
Q

Pt. with the following S/SX ==> ?

  • Osler nodes (tender subcutaneous lesions on finger or toe pads)
  • Splinter hemorrhages
  • Janeway lesions (painless erythematous lesions on palms or soles)
A

endocarditis; Multiple positive blood cultures are required to diagnose bacterial endocarditis.

23
Q

____________ is a systolic murmur with mid systolic click due to excess valvular tissue prolapsing into the left atrium

A

Mitral prolapse

24
Q

Papillary muscle damage post MI causes what murmur?

A

mitral regurgitation

25
Q

Mitral valve prolapse/hypertrophic cardiomyopathy causes what murmur?

A

mitral regurgitation

26
Q

LV dilation with stretching of mitral valve ring causes what murmur?

A

mitral regurgitation

27
Q

Rheumatic heart disease causes what murmur?

A

mitral regurgitation

28
Q

Infective endocarditis with valvular damage causes what murmur?

A

mitral regurgitation

29
Q

Tuberous sclerosis causes what murmur?

A

mitral regurgitation

30
Q

What is the outcome of chronic mitral regurgitation?

A

the left atrium compensates to the increased volume by dilating and increasing compliance which leads to increased incidence of fibrillation rhythms.

31
Q

What murmur results in increased left atrium pressures and pulmonary congestion?

A

Acute mitral regurgitation

32
Q

what murmur is characterized by a holosystolic high pitched “blowing” murmur, heard loudest at the apex, radiates to the axilla.

A

mitral regurgitation

33
Q

Mitral regurgitation sounds like?

A

holosystolic high pitched “blowing” murmur, heard loudest at the apex, radiates to the axilla.

34
Q

What murmur can result in left atrial dilation and hypertrophy?

A

Mitral Stenosis; this can result in atrial fibrillation, which is associated with stasis and thrombus formation leading to possible embolization.

35
Q

What murmur is heard as an opening snap followed by mid- to late-diastolic rumbling?

A

Mitral stenosis

36
Q

What murmur is associated with a crescendo-decrescendo systolic ejection murmur radiating to the carotids.

A

Aortic stenosis

37
Q

What murmur radiating to the carotids?

A

Aortic stenosis

38
Q

What murmurs can hear in the aortic area?

A
  • aortic stenosis
  • flow murmurs (normal/physiologic murmurs)
  • aortic valve sclerosis
39
Q

The following murmurs can be heard where on the chest?

  • aortic stenosis
  • flow murmurs (normal/physiologic murmurs)
  • aortic valve sclerosis
A

aortic area

40
Q

What murmurs can you hear at the left sternal border?

A

diastolic: aortic and pulmonic regurg.
systolic: HCM

41
Q

What murmurs can you hear at the pulmonic area?

A

systolic ejection murmurs: pulmonic stenosis, flow murmurs.

42
Q

What murmurs can you hear at the tricuspid area?

A

holosystolic: tricuspid regurg, VSD
diastolic: tricuspid stenosis, ASD d/t increase flow across the tricuspid vavle.

43
Q

What murmurs can you hear at the mitral area?

A

holosystolic murmur: mitral regurg.

diastolic murmur: mitral stenosis

mitral valve prolapse

44
Q

What does inspiration do?

A

increase venous return to right atrium ==> increase intensity of RIGHT heart sounds.

45
Q

What does hand grip do?

A

increase afterload. increases intensity of MR, AR, and VSD.

decreases HCM.

46
Q

How does Valsalva effect murmurs?

A

DECREASE PRELOAD!!!

decreases the intensity of most murmmursl INCREASES HCM!

later onset of click/murmur in MVP.

47
Q

How does standing up from sitting effect murmurs?

A

DECREASE PRELOAD!!!

decreases the intensity of most murmmursl INCREASES HCM!

later onset of click/murmur in MVP.

48
Q

What does rapid squatting do to murmurs?

A

increases: preload, afterload, and venous return.

DECREASES HCM.

increases intensity of aortic stenosis.

49
Q

What bedside maneuver increases intensity of aortic stenosis?

A

rapid squatting

50
Q

What bedside maneuver decreases the murmur ~w/ HCM?

A

rapid squatting

51
Q

What bedside maneuver INCREASES the murmur ~w/ HCM?

A

Valsalva or standing up from sitting; decreases preload.

52
Q

continuous machine-like murmur, loudest at S2 ==>

A

PDA

BT_Step1_NTK (28 decks)

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