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Cardiovascular system > Heart murmurs > Flashcards

Heart murmurs Flashcards

1
Q

valve stenosis

A

narrowing of affected valve that causes decreased flow of blood through the valve which results in backing up of blood before the valve

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2
Q

valve regurgitation

A

valve cannot properly close. This causes some back flow of blood through the valve in the reverse direction when, or after, the heart contracts.

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3
Q

regurgitation also called

A

incompetence insufficiency

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4
Q

Valve stenosis and regurgitation have different effects depending

A

which valve they affects

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5
Q

The different pathologies will also have differing

A

sounds and patterns on auscultation.

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6
Q

the sound produced during the auscultation of a heart murmur is caused by

A

turbulent blood flow generated by pathology affecting the heart valve

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7
Q

four valves of the heart

A

tricuspid (RA) mitral (LA) pulmonary aortic

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8
Q

which valves are commonly affected with murmus

A

mitral aortic

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9
Q

listening to the heart sounds acronymn

A

All Prostitutes Take Money

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10
Q

All

A

aortic - Second right intercostal space (ICS), right sternal border

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11
Q

Prostitutes

A

pulmonary - Second left intercostal space (ICS), left sternal border

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12
Q

Take

A

tricuspid - Fourth left ICS, left sternal border

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13
Q

Money

A

mitral - Fifth ICS, left mid-clavicular line

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14
Q

first heart sound (S1) represents

A
  • closure of mitral valve and tricuspid valve - beginning of ventricular systole - loudest at the apex and lower left sternal border
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15
Q

second heart sound (S2) represents

A
  • closure of aortic valve and pulmonary valve - end of ventricular systole - loudest at the base
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16
Q

mitral valve stenosis

A

narrowing of the mitral valvae

17
Q

why does mitral valve stenosis occur

A

rheumatic fever (99.9%) - commissural fusion of valve leaflets

18
Q

mitral valve stenosis affects

A

pulmonary circulation and the left atria

19
Q

mitral valve stenosis and pulmonary ciruclation

A

backing up of blood into the pulmonary circulation causes damage and fibrosis of the vasculature which leads to increases RESISTANCE to blood flow - results in pulmonary hypertension

20
Q

pulmonary hypertension (caused by mitral valve stenosis) causes

A

fluid to be forced out of the capillaries causing pulmonary oedema

21
Q

mitral valve stenos and left atrial dilation

A

occurs as the atria tries to pump harder agains the stressed valve to move blood through it. - leads to fibrosis and remodelling fo the atria to repair damaged tissue caused by stretching of the atria

22
Q

fibrosis of the heart

A

interrupts electrical pathways leading to ectopic beats which can cause atrial fibrillation

23
Q

side affects of left atrial dilation

A

can compress the oesophagus causing dysphagia can impress the recurrent laryngeal never which runs close to the oesophagus–> give patient a hoarse voice

24
Q

how is mitral valve stenosis heard

A

diastolic rumble murmur between S2 and S1

25
Q

aortic valve stnesosi

A

narrowing of the aortic valve

26
Q

causes of aortic valve stenosis (3)

A
  1. degeneration of the valve e.g. due to calcification or fibrosis with age
  2. congenital bicuspid valve (endocarditis)
  3. chronic rheumatic fever which causes commissural fusion of the valve leaflets
27
Q

effects of aortic valve stenosis (2)

A
  1. Left ventricular hypertorphy as the ventricle must pump harder to focer the blood through the narrowed valve ( can lead to left sided heart failure)
  2. Microangiopathic haemolytic anaemia (MAHA)
28
Q

how is aortic stneosis heard?

A

as a cresendo-decresendo murmur

29
Q

Microangiopathic haemolytic anaemia (MAHA)

A

RBCs are sheared/ damaged as they are pumped through the stenosed valve

30
Q

mitral valve regurgitiation

A

pathology affecting the mitral valve resulting in blood flowing backwards through it on ventiruclar contraction

31
Q

causes of mitral valve regurgitation (4)

A
  1. Myxomatous degeneration - degeneration of the valve (idiopathic)
  2. Damage to the papillary muscles after MI.
  3. Left sided heart falure which causes left ventiruclar dilation
  4. Rheumatic fever which causes fibrosis odf the valve which disrupts the seal fo the valve allowing blood to leak through
32
Q

mitral regurg and damave to the papillary muscles after MI

A

Damage to the papillary muscle means it is less effective at anchoring the chordae tendineae and therefore less effective at preventing the valves from prolapsing. This allows blood to flow backwards through the prolapsed mitral valve.

33
Q

mitral regurg and left sided heart failure which causes left ventiruclar dilation

A

. This dilation causes stretching of the valve so it no longer forms a tight seal, allowing blood to leak through.

34
Q

how is mitral valve regurg heard

A

as a holosytolic murmur

35
Q

effects of mitral valve regurg

A

Mitral valve regurgitation allows blood to leak back into the left atrium. This increases the preload of the ventricle as more blood enters the ventricle on diastole. The left ventricle hypertrophies to cope with the increased volume of blood which can lead to left sided heart failure.

36
Q

aortic valve regurgitation

A

is pathology affecting the aortic valve resulting in blood flowing backwards though it after ventricular contraction

37
Q

causes of aortic valve regurg (3)

A
  1. aortic root dilation which causes the leaflelt sto be pulled apars so they no longer form a tight seal
  2. valve damage caused by endocarditis or rheumatic fever
  3. connective tissue disorder e.g. marfans syndrome
38
Q

effects of of aortic valve regurg (2)

A
  1. Blood flows back intot he elfgt ventircle during diastole causing a reduced diastolic pressure. Systolic pressure does not change
    * decreased diastolic pressure increases the pulse pressure and can be felt as a bounding pulse
  2. Blood flows back intot he left venticle which increases the stroke volume. Heart hypertorphies to cope with increased storke volume- left sided failure
39
Q

how is aortic valve regurg heart

A

as a decrescendo early diastolic murmur between S1 and S2

Cardiovascular system (30 decks)

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