Murmurs

Question 1

What are the grades of murmurs?

Answer 1

Grade I: Difficult to hear
Grade II: Quiet
Grade III: Easy to hear
Grade IV: Easy to hear with a palpable thrill
Grade V: Audible with stethoscope barely touching the chest
Grade VI: Audible with stethoscope off the chest

Question 2

What are the features of aortic stenosis on examination?

Answer 2

Ejection-systolic,crescendo-decrescendo murmur

Signs: Thrill in the aortic area on palpation
Slow rising pulse
Narrow pulse pressure (the difference between systolic and diastolic blood pressure)
Exertional syncope

Question 3

What are the features of aortic regurgitation?

What disorders are causes of AR?

Answer 3

Early diastolic murmur
Thrill in the aortic area on palpation
Collapsing pulse
Wide pulse pressure
Heart failure and pulmonary oedema

Ehlers Danlos syndrome, Marfan syndrome

Question 4

What is S1 and S2 heart sounds?

Answer 4

S1 = mitral and tricuspid valves closing
S2 = aortic and pulmonary valves closing

Between S1 and S2 sound is systole
Between S2 and S1 sound is diastole

Question 5

Features of mitral stenosis?

Most common causes of mitral stenosis?

Answer 5

Mid diastolic low pitched rumbling murmur
Tapping apex beat
Malar flush
Atrial fibrillation

Rheumatic heart disease
Infective endocarditis

Question 6

Features of mitral regurgitation?

What disorders are associated with MR?

Answer 6

Pan systolic, high pitched whistling murmur radiating to axilla
Third heart sound
Thrill in mitral area
Signs of left sided heart failure
AF

Infective endocarditis
Rheumatic heart disease
Ehlers Danlos syndrome
Marfan syndrome