Heart Murmurs Flashcards
(49 cards)
1
Q
PC AS
A
SAD
2
Q
Features AS
A
Ejection systolic 1-6 Aortic - Crescendo-decrescendo Carotids Systemic
3
Q
Systemic AS
A
4th HS quiet S2 Heaving apex Ejection click Slow rising pulse Narrow pulse pressure
4
Q
ECG AS
A
LVH / LV strain pattern
5
Q
CXR AS
A
NA
6
Q
DDX AS
A
Aortic sclerosis
HOCM
PS
MR
7
Q
Surgical treatment AS
A
Symptomatic- prognosis 3 years
A symptomatic with gradient > 50mmHg
Valvuloplasty if unfit for surgery
8
Q
Causes of AR
A
RHD
IE
SYPHILIS
Bicuspid
HTN
AD
Marfans
RA
Ank spon
9
Q
PC AR
A
SOB
Fatigue
Palpitations
10
Q
Features of AR
A
Early diastolic 1-4 LLSE sitting up and exp Breath like high pitch blowing - Systemic
11
Q
Systemic features of AR
A
4
S3 Thrusting, displaced Collapsing pulse Wide pulse pressure 5 signs
12
Q
5 signs of AR
A
Corrigans Quinke DeMusset Duroziez Troubes
13
Q
Corrigans
A
Exaggerated carotid
14
Q
Quinke
A
Pulsating nail bed
15
Q
DeMusset
A
Heading nodding
16
Q
Duroziez
A
Diastolic femoral murmur
17
Q
Troubes
A
Pistol shot femorals
18
Q
CXR AR
A
Cardiomegaly
Heart failure
19
Q
DDX AR
A
PR
Graham Steele
20
Q
Treatment AR
A
Diuretics
Vasodilators
21
Q
Surgery AR
A
More than mild disease
DONT WAIT UNTIL IRREVERSIBLE
22
Q
MS Causes
A
Rheumatic heart disease
23
Q
PC MS
A
SOB Fatigue Pulmonary oedema Haemoptysis RHF
24
Q
Features of MS
A
Mid- diastolic 1-4 Apex On LHS exp Rumbling low pitched - Systemic
25
Systemic features of MS
6
```
Opening snap
Tapping apex
A fib
LOUD S1
Mitral facies
Signs RHF
```
26
ECG MS
```
A fib (irregular r r, narrow QRS, no P waves)
P mitrale= bifid P waves
```
27
CXR MS
Large LA
| Pulmonary venous congestion
28
DDX MS
```
Austin flint (severe AR)
Carey Coombs (rheumatic fever)
TS (usually rheumatic)
```
29
Treatment of MS
A fib treatment and anti coagulation
| Diuretics
30
Surgery MS
```
Valvuloplasty- more than mild
Valve replacement/ repair
- associated MR
- rigid, calcified
- persistent LA thrombus
```
31
Causes of MR
7
RHD
IE
MVP
Post MI pap rupture
LV dilation
Marfans
SLE
32
PC MR
SOB
FATIGUE
other LVF
33
Features of MR
```
Pan systolic
1-6
Apex
-
Blowing
Axilla
Systemic
```
34
Systemic features of MR
S3 gallop- quiet S1, obliterated S2
Thrusting, displaced
A fib
Audible click in valve prolapse
35
ECG MR
A fib
| VEBS
36
CXR MR
Cardiomegaly (late)
| Cardiac failure
37
Differential MR
VSF (esp post mi)
TR
AS
38
Treatment MR
A fib and anticoagulant
Diuretics
ACE inhibitors -- since HTN worsens MR
39
Surgery MR
More than mild
LV dysfunction
DONT WAIT IRREVERSIBLE
40
Grade 1 murmur
Very faint, just audible, EXPERT optimal
41
Grade 2 murmur
Quiet, just audible- non expert optimal
42
Grade 3 murmur
Moderately loud
43
Grade 4 murmur
LOUD + palpable thrill
44
Grade 5 murmur
VERY LOUD + thrill + hear off chest with stethoscope
45
Grade 6 murmur
VERY LOUD + thrill + hear without stethoscope
46
Aortic sclerosis
```
A symptomatic
Doesn't radiate to carotids
No slow rising pulse
Normal pulse pressure
S2= normal, loud
```
47
Indications prosthetic valve
Elderly
| Can't use warfarin-- pregnant/ case by case
48
6 complications of prosthetic valves
```
Structural valve failure
Para valvular leak
Thrombus/ obstruction
IE
intra vascular haemolysis
(Warfarin related)
```
49
Causes of AS
RHD
Ca bicuspid- 50-60
Ca tricuspid- 70+
