Heart Murmurs Flashcards Preview

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Flashcards in Heart Murmurs Deck (32):
1

Crescendo-decrescendo systolic ejection murmur.

Aortic Stenosis

2

LV >> aortic pressure during systole. Loudest at heart base; radiates to carotids.

Aortic Stenosis

3

“Pulsus parvus et tardus”—pulses are weak with a delayed peak

Aortic Stenosis

4

Can lead to Syncope, Angina, and Dyspnea on exertion (SAD)

Aortic Stenosis

5

Often due to age-related calcification or early-onset calcification of bicuspid aortic valve.

Aortic Stenosis

6

Holosystolic, high-pitched “blowing murmur.”

mitral or tricuspid regurg

7

loudest at apex and radiates toward axilla.

Mitral Regurg

8

often due to ischemic heart disease (post-MI), MVP, LV dilatation

Mitral Regurg

9

loudest at tricuspid area and radiates to right sternal border.

Tricuspid Regurg

10

commonly caused by RV dilatation.

Tricuspid Regurg

11

Rheumatic fever and infective endocarditis can cause (two murmurs) what are they?

Mitral or Tricuspid Regurg

12

Late systolic crescendo murmur with midsystolic click (MC; due to sudden tensing of chordae tendineae

Mitral valve prolapse (MVP)

13

Most frequent valvular lesion

Mitral valve prolapse (MVP)

14

Best heard over apex. Loudest just before S2. Usually benign

Mitral valve prolapse (MVP)

15

Can predispose to infective endocarditis

Mitral valve prolapse (MVP)

16

Can be caused by myxomatous degeneration (1° or 2° to connective tissue disease such as Marfan or Ehlers-Danlos syndrome), rheumatic fever, chordae rupture

Mitral valve prolapse (MVP)

17

Holosystolic, harsh-sounding murmur. Loudest at tricuspid area.

VSD

18

High-pitched “blowing” early diastolic decrescendo murmur.

Aortic Regurgitation

19

Long diastolic murmur and signs of hyperdynamic pulse when severe and chronic causing head bobbing

Aortic Regurgitation

20

Often due to aortic root
dilation, bicuspid aortic valve, endocarditis, rheumatic fever.

Aortic Regurgitation

21

Progresses to left HF.

Aortic Regurgitation

22

Follows opening snap (OS; due to abrupt halt in leaflet motion in diastole, after
rapid opening due to fusion at leaflet tips).

Mitral Stenosis

23

Delayed rumbling late diastolic murmur ( decreased interval between S2 and OS correlates with increased severity).

Mitral Stenosis

24

LA >> LV pressure during diastole.

Mitral Stenosis

25

Often occurs 2° to rheumatic fever

Mitral Stenosis

26

Continuous machine-like murmur loudest at S2

PDA

27

Often due to congenital rubella or prematurity. Best heard at left infraclavicular area.

PDA

28

BEDSIDE MANEUVER:

Inspiration (increased venous return to right atrium)

increased intensity of right heart sounds

29

BEDSIDE MANEUVER:

Hand grip (increased afterload)

increased intensity of MR, AR, VSD murmurs

decreased in hypertrophic cardiomyopathy murmurs

MVP: later onset of click/murmur

30

BEDSIDE MANEUVER:

Valsalva (phase II), standing up (decreased preload)

decreased intensity of most murmurs (including AS)
BUT increased intensity of hypertrophic cardiomyopathy murmur

MVP: earlier onset of click/murmur

31

BEDSIDE MANEUVER:

Rapid squatting (increase venous return, increase preload)

decreased intensity of hypertrophic cardiomyopathy murmur and increased intensity of AS murmur

MVP: later onset of click/murmur

32

Wide fixed splitting of the second heart sound. Can lead to chronic pulmonary hypertension

ASD: chronic pulm HTN will lead to L--> R shunting and Eisenmenger syndrome