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Flashcards in Murmurs Deck (11)
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What are the only definitive methods of identifying structural and functional abnormalities?

-Cardiac Cath


-Best heard at 2nd RICS
-radiates to neck and LSB
-often loud w/ a thrill

Aortic Stenosis
(best heard when patient sitting and leaning forward)


-Best heard at 2nd to 4th LICS
-radiates to apex and RSB
-grade 1-3
-high pitch and blowing

Aortic Regurg
(best heard when patient sitting and leaning forward; full exhalation)


-Best heard at apex w/ little or no radiation
-grade 1-4
-low pitch
-S1 accentuated
-opening snap follows S2

Mitral Stenosis
(best heard w/ patient in LLDB; full exhalation)


-Best heard at apex w/ radiation to the L axilla
-medium to high pitch
-S2 often decreased
-apical impulse is prolonged

Mitral Regurg


-late systolic murmur
-midsystolic click

Mitral Valve Prolapse
(most patients are thin female w/ minor chest deformities)


-murmur at LLSB
-radiation to right sternum and xiphoid area
-meidum, blowing
-increases slightly w/ inspiration
-JVP often elevated

Tricuspid Regurg


-murmur at 2nd and 3rd LICS
-radiation to L shoulder and neck
-soft to loud; possible thrill
-medium to harsh

Pulmonary stenosis


Tx of aortic and mitral valve disorders

only effective long term tx are surgical repair, replacement of defective valve & balloon valvuloplasty
-If good exercise tolerance may tx medically w/ diuretics and vasodilators for pulmonary congestion w/ digoxin or beta-blockers for dysrhythmias


In all cases of tricuspid and pulmonic disorders

right sided pressure overload less to right sided cardiomegaly system venous congestion and R sided heart failure
-often present w/ exercise intolerance
-JVD, peripheral edema, and hepatomegaly reflect systemic venous congestion


Tx of tricuspid and pulmonic disorders

-sodium restriction and diuretic therapy
-underlying conditions causing pulmonary HTN and tx w/ arterial vasodilators or positive inotropic a gens
-definitive tx = surgical repair, valvuloplasty, or replacement valve