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Flashcards in Murmurs Deck (25)
1

Bedside maneuver: inspiration

- increases intensity of right heart sounds

2

Bedside maneuver: expiration

- increases intensity of left heart sounds

3

Bedside maneuver: hand grip (increased systemic vascular resistance)

- increases intensity of MR, AR, VSD, MVP

- decreases intensity of AS, hypertrophic cardiomyopathy murmurs

4

Bedside maneuver: valsalva (decreased venous return)

- decreases intensity of most murmurs

- increases intensity of MVP, hypertrophic cardiomyopathy murmurs

5

Bedside maneuver: rapid squatting (increased venous return, increased preload, increased afterload with prolonged squatting)

- decreases intensity of MVP, hypertrophic cardiomyopathy murmurs

6

Description of MR

- holosystolic, high-pitched "blowing murmur" that radiates towards axilla

- systolic murmur

7

Maneuvers that can increase intensity of MR

- increased TPR (squatting) or LA return (expiration)

8

Description of TR

- holosystolic, high pitched murmur that radiates towards right sternal border

- systolic murmur

9

Maneuvers that can increase intensity of TR

- increased RA return (inspiration)

10

Description of AS

- crescendo-decrescendo systolic murmur following ejection click
- radiates towards carotids/heart base

- systolic murmur

11

Description of VSD

- holosystolic, harsh-sounding murmur

12

Maneuvers that increase VSD

- hand grip due to increased afterload

- systolic murmur

13

Description of MVP

- late systolic crescendo murmur with midsystolic click

14

Maneuvers that increase MVP

- decreased venous return (standing or Valsalva)

- systolic murmur

15

Description of AR

- high pitched "blowing" decrescendo murmur

- bounding pulses, and head bobbing

- diastolic murmur

16

Maneuvers that increase or decrease AR

- increase: hand grip

- decrease: vasodilators

17

Description of MS

- follows opening snap

- delayed rumbling

- best heard in left lateral decubitus

- diastolic murmur

18

Description of PDA

- continuous machine-like murmur

19

Description of normal splitting

- delayed closure of pulmonic valve during inspiration

20

Description of wide splitting

- delayed closure of pulmonic valve regardless of breath
- an exaggeration of normal splitting

21

Conditions that can cause wide splitting

- any condition that delays RV emptying such as pulmonic stenosis or RBBB

22

Description of fixed splitting

- pulmonic closure is greatly delayed

23

Conditions that can cause fixed splitting

- ASD (left to right shunt)

24

Description of paradoxical splitting

- P2 sound occurs before delayed A2 sound

25

Conditions that can cause paradoxical splitting

- any condition that delays LV emptying such as aortic stenosis or LBBB