Murmurs Flashcards
What valves are heard in S1?
mitral and tricuspid
what valve is heard at S2?
Aortic and Pulmonic (semi-lunar valves
When do you hear S3?
extra fluid –> HF and preg
When do you hear S4?
uncontrolled HTN and Left ventricular hypertrophy
The S4 sound is best heard at the apex of the heart during diastole when the patient is laying on their left side with arms raised. An S4 sound can also be heard in the elderly and be a normal finding if there is no history of cardiac disease in that patient.
What if hear a split S2 in INspir and Exp
Refer,
only normal during inspiration.
What heart sound is heard at the base?
S2
Murmur heard at 2nd intercostal space, right sternal border and radiates to the neck.
Aortic stenosis
Nemonic for diastolic murmurs
Ms. ARD also ARMS
Mitral stenosis
Aortic Regurgitation
(diastolic)
Diastolic murmurs are always refer.
MR PASS MVP
Mirtal regurg: radiates to armpit (MMM is in arMpit)
Physiological murmur
Aortic Stenosis: radiating to the neck. (when you say Ah you move your neck)
Mitral valve prolapse: can here a click (morfin synonym young children)
only murmurs that radiate are systolic.
What grade will we fill a palpable thrill?
grade 4
what condition?
purple legs, hyperpigmented or shiny
pain relieved rest and dangling
ulcer on toe
PAD
intermittent claudication
-treatment: continue walking and take breaks
dig with ABI
How do you calculate ABI?
Calculated (indiv by each leg)
BP ankle systolic number/ BP for arm systolic number
less than 0.9=PAD
What is a risk factor for PAD?
smoking
red brown color legs, hyperpigmented on dark skin and edematous
chronic venous insufficient
fifth intercostal space, left midclavicular line radiating to the axilla.
Mitral regurgitation
