Heart Sounds

Question 1

What is the common cause of mitral stenosis?

Answer 1

Rheumatic fever.

Question 2

What are some other causes of mitral stenosis?

Answer 2

• Congenital
• SLE
• RA

Question 3

What are some complications of mitral stenosis?

Answer 3

• AF
• Embolism
• Infective endocarditis

Question 4

What sort of murmur would you get with mitral stenosis?

Answer 4

• Mid-diastolic murmur +/- Apical rumbling
• Loud first heart sound
• Tapping apex

Question 5

In what types of conditions is a mitral valve prolapse idiopathic?

Answer 5

Connective tissue disorders (e.g. Marfan’s, Ehlers-Danlos syndrome)

Question 6

If a patient has a mitral valve prolapse and do not have a connective tissue disorder, how else might they acquire it?

Answer 6

Ischaemic heart disease

Question 7

When would someone with a mitral valve prolapse need to be referred to a cardiologist?

Answer 7

When they have associated mitral regurgitation.

Question 8

What sort of murmur would you get with a mitral valve prolapse?

Answer 8

• Mid systolic click
• Apical blowing late systolic murmur
• Radiates to the axilla

Question 9

What sort of murmur would you get with aortic stenosis?

Answer 9

• Loud ejection systolic murmur
• Area: Upper right sternal edge. (Aortic area)
• Radiation: Carotids.
• Associated: Slow rising carotid pulse

Question 10

What are the 3 causes of aortic stenosis?

Answer 10

1. Congenital bicuspid valve
2. Rheumatic fever
3. Senile calcification

Question 11

What is the classic triad of aortic stenosis?

Answer 11

• Chest pain
• Heart failure
• Syncope

Question 12

What sort of murmur would you get with aortic regurgitation?

Answer 12

• Early diastolic murmur
• Area: aortic area
• Associated features: head loudest with patient sitting forward in expiration.

Question 13

What can cause aortic regurgitation?

Answer 13

• Marfan’s syndrome
• Ankylosing spondylitis
• RA
• SLE
• HTN

Question 14

What murmur is a machinery like murmur in children?

Answer 14

Patent Ductus Arteriosus

Question 15

Are most PDA murmurs symptomatic or asymptomatic?

Answer 15

Asymptomatic

Question 16

What you might find in the history of a patient who has a PDA?

Answer 16

• Premature birth
• Perinatal distress
• Born at extreme altitude
• Failure to thrive
• Low birth weight

Question 17

What can be used to close the PDA if not other heart abnormalities?

Answer 17

Indomethacin

Question 18

What are some features of severe aortic sttenosis?

Answer 18

• Narrow pulse pressure
• Slow rising pulse
• Delayed ESM
• Soft/Absent S2
• Thrill
• LVH or LVF