7 - Heart Sounds and Murmurs Flashcards
S3 is heard ___
after S2
S4 is heard ____
before S1
what causes S3?
resistance to early LV filling > sign of decompensated heart failure due to volume overload
what causes S4?
exaggerated atrial kick - due to pressure overload in LVH or aortic stenosis
what causes physiologic splitting of S2?
during inspiration, pressure in lungs is even lower, so more blood is drawn out of RV > takes longer to empty > pulmonic valve closes after aortic
wide and fixed splitting of S2 most often indicates
atrial septal defect
which extra sounds can be heard rarely in normal young subjects?
both s3 and s4
atrial septal defect murmur
wide and fixed splitting of S2 due to increased shunting of blood from LA > RA leads to increased filling of RV > takes longer to empty > pulmonic closes after aortic
ventricular gallop is characterized by all except:
a. soft low pitched
b. early diastolic
c. late diastolic
d. a and b
c
atrial gallop is all except:
a. normal in younger subjects
b. late diastolic
c. active atrial contraction
d. sharp high pitch
d
where can you hear physiologic splitting best?
base - 2nd intercostal space
holosystolic murmur
mitral regurg
crescendo/decrescendo systolic murmur
aortic stenosis
diastolic rumble after quiet period
mitral stenosis
early diastolic murmur
aortic regurg
