Heart Murmurs Flashcards Preview

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Flashcards in Heart Murmurs Deck (16):
1

Cause of wide split S2

Delay of RV emptying b/c aortic closes after pulmonic
Heard more on inspo
Pulm stenosis

2

Cause of fixed split S2

ASD
P2 is delayed the same in inspo + expo because constant volume overload in the R heart

3

Cause of paradoxical splitting

Anything that delays aortic valve closure - hear pulmonic closing before aortic
Split gets eliminated on *expo* b/c P2 moves closer to A2
**Aortic stenosis

4

Systolic C/D murmur
At base

Aortic stenosis - only C/D murmur
Radiates to carotids
Pulsus parvus et tardus

5

Holosystolic blowing murmur (2) vs harsh sounding murmur (1)

Blowing
1. Mitral regurg if @ apex
2. Tricuspid regurg if @ L sternal border
Harsh = VSD @ L sternal border

6

Mid systolic click followed by late systolic crescendo murmur at apex

Mitral valve prolapse

7

Early diastolic blowing murmur

Aortic regurg
Head bobbing, hyper dynamic pulse, wide PP
"Sit up + lean forward, hold breath at end of expiration"

8

S2 then OS + delayed rumbling late diastolic murmur

Mitral stenosis

9

What indicates the severity of mitral stenosis via murmur

How close S2 and OS are b/c indicates rising pressuring in the RA

10

Describe PDA murmur

Continuous through systolic + diastolic
Machine like - loudest @ S2

11

Which murmurs are louder on inspiration

R heart b/c increase intra-thoracic P = more venous return to R

12

What does hand grip do? Which murmur are more (3) and less intense (1) with this maneuver?

Increases after load (peripheral vasoconstriction)
Louder:
1. MR
2. AR
3. VSD
Softer: hypertrophic CM

13

Name the ways you move MVP click: 2 ways to move it later in diastole, 1 way earlier

Later
1. Rapid squat
2. Hand grip
Earlier
1. Valsalva // standing up

14

How do most murmurs change with valsalva//standing up? Hypertrophic CM?

Decrease preload
Decrease HCM
Increase most others

15

How does rapid squat change HCM vs AS murmur?

Increasing venous return -> preload, AND increasing after load
Less intense HCM
More intense AS

16

Why might a baby murmur not present at birth?

If murmur is R -> L, normal at first
Then as increase pulm P, will reverse into L -> R and become audible
Ex: VSD