Murmurs

Question 1

Murmur in aortic stenosis?

Answer 1

Ejection systolic

Question 2

Murmur in mitral stenosis?

Answer 2

Mid-diastolic

Question 3

Murmur in aortic regurgitation?

Answer 3

Early diastolic

Question 4

Murmur in mitral regurgitation?

Answer 4

Pan-systolic

Question 5

Right-sided murmurs (tricuspid + pulmonary) are louder on

Answer 5

INspiration because blood goes IN to the right side of the heart

Question 6

Left-sided murmurs (mitral + aortic) are louder on

Answer 6

EXpiration

because blood EXits the heart from the left side

Question 7

What are the causes of a pan-systolic murmur?

Answer 7

Mitral/tricuspid regurgitation

VSD

Question 8

What is the cause of a continuous machinery murmur?

Answer 8

PDA

Question 9

What does S1 correspond to?

Answer 9

Mitral and tricuspid valve closure

Question 10

What does S2 correspond to?

Answer 10

Aortic and pulmonary valve closure

Question 11

What does a quiet S1 or S2 indicate?

Answer 11

Pericardial effusion/tamponade

Question 12

What causes an S3 sound?

Answer 12

Blood coming into contact with a compliant (dilated) ventricle

Question 13

What is S3 a sign of?

Answer 13

Can be normal in adults up to 30

• Mitral regurgitation
• HF
• Dilated cardiomyopathy

Question 14

What causes an S4 sound?

Answer 14

Blood coming into contact with a non-compliant ventricle during atrial contraction (forceful contraction)

Question 15

What is S4 a sign of?

Answer 15

• LVH
• Post MI fibrosis
• Failure of relaxation – diastolic heart failure