Heart Murmurs

Question 1

What are the main causes of mitral stensis?

Answer 1

Rheumatic heart disease

Question 2

What is the presentation of MS?

Answer 2

SOB + fatigue
Pulmonary oedema
haemoptysis
RHF

Question 3

What type of murmur is MS

Answer 3

Mid-diastolic

Question 4

What are the grades of MS

Answer 4

1-4

Question 5

What is MS heard loudest?

Answer 5

Apex area with the patient lying on LHS in expiration

Question 6

What is the nature of MS murmur?

Answer 6

rumbling (low-pitched) in nature and does not radiate

Question 7

What are the associated features of MS murmur?

Answer 7

opening snap, tapping apex, AF, loud 1st Heart sound, mitral facies and signs of RHF

Question 8

What are the main primary causes of mitral regurgitation?

Answer 8

rheumatic heart disease
infective endocarditis
valve prolapse
Papillary muscle rupture
marfans
SLE

Question 9

What are the main secondary causes of MR

Answer 9

LV dilation

Question 10

What is the presentation of MR?

Answer 10

SOB + fatigue

LVF - orthopnoea, PND

Question 11

What type of mumur is MR?

Answer 11

pansystolic

Question 12

What are the grades of MR murmur?

Answer 12

1-6

Question 13

What is MR head loudest?

Answer 13

Apex area with the patient lying in supine at 45degress

Question 14

What is the nature of MR?

Answer 14

Blowing in nature

Question 15

Where does MR radiate to?

Answer 15

the axilla

Question 16

What are the assoicated features of MR?

Answer 16

3rd heart sounds
thrusting displaced apex
quiet first HS
obliterated 2nd HS
AF
Audible 'click' in valve prolapse

Question 17

What are the main causes of aortic stenosis?

Answer 17

Rheumatic heart disease
Calcified bicuspid valve
Calcified tricuspid valve

Question 18

What is the presentation of AS?

Answer 18

SOB
Syncope
Angina

Question 19

What type of murmur is AS

Answer 19

ejection systolic

Question 20

What are the grades of AS?

Answer 20

1-6

Question 21

Where is AS heard loudest?

Answer 21

in the AORTIC AREA

Question 22

What is the nature of AS?

Answer 22

crescendo-decresendo

Question 23

Where does AS radiate to?

Answer 23

the carotids

Question 24

What are the associated features of AS?

Answer 24

4th HS
heaving apex
slow rising pulse
narrow pulse pressure
ejection click
quiet 2nd HS

Question 25

What are the features of aortic sclerosis?

Answer 25

``` Asymptomatic Does no radiate to the carotids No slow rising pulse Normal pulse pressure 2nd HS = normal ```

Question 26

How do you describe a heart murmur?

Answer 26

``` Timing Intensity Position of murmur Position of patient Quality Radiation Systemic features ```

Question 27

What are the main causes of aortic regurgitation

Answer 27

``` Rhuematic heart disease infective endocarditis Luetic heart disease Bicuspid valve Hypertension Aortic dissection Marfan's Rheumatoid Arthritis Ankylosing spondylitis ```

Question 28

What is the presentation of AR

Answer 28

SOB + fatigue | palpitations

Question 29

What type of murmur is AR?

Answer 29

Early diastolic

Question 30

What are the grades of AR?

Answer 30

1-4

Question 31

Where is AR heard loudest?

Answer 31

on the left sternal edge with the patient sitting up in expiration

Question 32

Whaat is the nature of AR murmur?

Answer 32

breath-like (high pitched)

Question 33

Where does AR radiate to?

Answer 33

it does not radiate

Question 34

What are the assoicated features of AR?

Answer 34

``` 3rd HS thrusting displacd apex beat collapsing pulse wide pulse pressure enonymous signs Austin-Flint murmur ```

Question 35

What are the eponymous signs of AR?

Answer 35

``` Corrigan's = exaggerated carotid pulse Quinke's = nail bed pulsation De Musset's = head noddinh Duroziez's = diastolic femoral murmur Traube's = 'pistol shot' femorals ```