Heart Sounds

Question 1

What is the 1st Heart Sound caused by?

Answer 1

Closure of the mitral and tricuspid valves

Question 2

What is the 2nd Heart Sound caused by?

Answer 2

Closure of the aortic and pulmonary valves

Question 3

S1:

Answer 3

Closure of mitral and tricuspid valves
Soft if long PR or Mitral Regurgitation
Loud in Mitral Stenosis

Question 4

S2:

Answer 4

Closure of aortic and pulmonary valves
Soft in aortic stenosis
Splitting during inspiration is normal

Question 5

S3: Third Heart Sound

S3 Ventricular Gallop

Answer 5

Diastolic filling of ventricles
Considered normal if under 30 years
May persist in women up to 50 years
Heard in left ventricular failure: 
- dialated cardiomyopathy
- constrictive pericarditis (pericardial knock)
- mitral regurgitation

Question 6

S4: Fourth Heart Sound

S4 Atrial Gallop

Answer 6

Aortic Stenosis (more blood in ventricles so harder for atria to contract against)
Hypertrophic Obstructive Cardiomyopathy (palpable - double apex beat)
Hypertension
Caused by atrial contraction against a stiff ventricle

Question 7

Pansystolic Murmur:

Answer 7

Murmur heart consistently throughout systole
Mitral Regurgitation
Coronary Artery Disease
Hypertrophic Cardiomyopathy

Question 8

New Murmur:

Answer 8

Infective endocarditis

Question 9

Late Systolic Murmur:

Answer 9

Mitral Valve Prolapse

Question 10

Crescendo-Decrescendo: Systolic Ejection Murmur

Answer 10

Aortic Stenosis
Coronary Artery Disease
Hypertrophic Cardiomyopathy

Question 11

Opening snap + Mid-diastolic (pre-systolic) Rumble

Answer 11

Mitral Stenosis

Question 12

Aortic Stenosis:

Answer 12

Crescendo Decrescendo
Systolic Ejection murmur
Slow rising pulse - Carotid pulse - small volume

Question 13

Decrescendo Diastolic Murmur

Answer 13

Aortic Regurgitation

Question 14

Aortic Regurgitation:

Answer 14

Decrescendo Diastolic Murmur

Collapsing pulse