Heart mumurs n shiz Flashcards
(40 cards)
Aortic Stenosis - Aetiology/causes
- Age related calcification
- RhF & IE
- William’s Bicuspid aortic valve
Marfans, Ehler-danlos syndrome
Aortic Stenosis - signs and symptoms
- ASYMPTOMATIC
- SOB, syncope on exertion, Anigina, LHF, palpitations
- Narrow Pulse Pressure
- Thrill felt
- Slow rising pulse (pulsus parvus et tardus)
- EJECTION SYSTOLIC MURMUR that may radiate to the carotids and apex
- Crescendo-decrescendo
- v severe: S2 split (comes after pulmonary valve closer)
- Gallavardin’s phenomenon (a holosystolic murmer that mimics MR)
Aortic Stenosis - Ix: ECHO, ECG and CXR
ECHO: Best for initial diagnosis.
ECG: LV hypertrophy (Tall R waves and deep S waves, LAD, T wave inversion)
CXR: Enlargement of the aorta and aortic valve calcification
Aortic Regurgitation - Aetiology/causes
- RhF, IE,
- Dilation of the aorta - HPN, coarction, aortitis
- Bicuspid aortic valve
- Marfan’s E-Ds
Aortic Regurgitation - signs and symptoms
- ASYMPTOMATIC
- SOB, syncope, chest pain, LHF, palpitations, orthopnoea, lung basal creps, JVP distension, low urine output
- Soft S1
- Wide pulse pressure
- Collapsing, water hammer pulse
- Displace apex beat
- Early decrescendo diastolic murmur that may radiate to the carotids
- If severe, can cause an Austin Flint murmur (–> low pitched mid diastolic rumbling murmur)
8 . Quincke’s - visible pulsation on nail bed - De Musset’s sign - head nodding in time with the pulse
- Trabe’s sign - pistol shot (loud systolic-diastolic murmur) heard over femoral
- Corrigan’s sign - visible pulsation in neck
- Becker’s sign - visible pulsation of the pupils and retinal arteries
Aortic Regurgitation - Ix: ECG, CXR, echo
- ECG: LV hypertrophy (Tall R in V1, deep S in V6, T wave inversion, LAD
- Cardiomegaly, Dilation of aorta
Mitral Stenosis - Aetiology/cause
- RhF, IE
- Dilation of the aorta (HPN, aortitis)
- Marfan’s ED
Mitral stenosis - Signs and symptoms
- Loud S1 w/ opening snap
- Parasternal heave
- Tapping in apex region
- Mid diastolic rumbling
- Irregularly irregular
6 Malar Flush - SOB, syncope, angina, HF, palpitations, orthopneoa, assymptomatic.
Mitral Stenosis - IX: ECG, CXR
ECG: Large R waves, inverted T waves, bifid p wave, AF
CXR: Dilation of ascending aorta, cardiomegaly
Mitral Regurgitation - Aetiology/causes
- RhF, IE
- Dilation of the aorta (HPN, aortitis)
- Marfan’s ED
Mitral Regurgitation - Signs and symptoms
1, SOB, syncope, angina, LHF (Oedema, decreased exercise tol, holosystolic mumur), palpitations,
- Pansystolic murmur that radiates to the axilla
- left ventricular dilation - Laterally displaced apex beat (and quiet S1)
- Pulse may be irreg/irreg
- S3, if there is left ventricular dysfunction
Mitral Regurgitation - Ix
ECG: Tall p waves, T wave inversion
CXR: Dilated cardiomeg, aortic enlargement
Description of a mitral valve prolapse
Barlow Mumur - Mid systolic click and end systolic murmur, best heard at the apex.
Tricuspid Regurgitation - aetiology
- IE!!!,RhF
- Marfans, E-D Syndrome
- RHF (can be due to LHF too)
Tricuspid Regurgitation - Signs and symptoms
- SOB, syncope, angina, RHF, hepatomegaly, acited, pitting oedema & ankle oedema
- Pansystolic murmur on left sternal edge/tricuspid area/at apex on inspiration (carvallo’s sign)
- JVP raised - V wave
- Parasternal heave
- Pulsitile liver if severe
Tricuspid regurgitation - Ix: Echo, ECG, CXR
ECHO: Ejection fractions, wall motion, etc.
ECG: Tall p wave
CXR: RHF –> ABCDE, R sided enlargement, hepatic venous congestion
Patent Ductus Arteriosus
Machinery like murmur throughout systole and diastole (GIBSON MURMUR), best heart in intraclavicular area. Can be due to a maternal rubella infection. Can lead to heart failure.
Ix: Echo
CAUSE?: Pulsus Alternans
Left ventricular systolic failure. Also, low ejection fraction, SV and end diastolic volume.
CAUSE? Pulsus paradoxes
Constrictive pericarditis, cardiac tamponade
Graham Steell murmur?
Pulmonary regurg (high pitched early diastolic, best heard on left sternal edge)
Carey-Coombs murmur
Mid diastolic murmur that can be caused by turbulent flow over a thickened mitral valve. Associated with acute RhF.
Cause of S3?
Rapid ventricular filling. After S2. due to HF. “kentucky”
Cause of S4?
Ventricular hypertrophy. Just before S1. Stiffened left ventricles, resulting from conditions such as hypertension, aortic stenosis, ischemic or hypertrophic cardiomyopathy.
In patient with mitral regurgitation, suggestive of acute onset of regurgitation due to the rupture of the chorda tendinae that anchor the Valvular leaflets. “tennessee”
Cause of a fixed wide splitting of S2
(it’s normally not heard as normally the aortic and pulmonary shut at nearly the same time)
It is due to an atrial septal defect
