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Flashcards in Murmurs Deck (10):
1

Splitting of S1

Occurs if there is pacing which triggers RV before LV
Or if mitral valve closure is delayed by high left atrial pressure, or an atrial myoxma

2

Splitting of S2

Wide fixed splitting in atrial septal defect

3

Soft heart sounds

Severe mitral regurgitation
Calcification
Severe aortic regurgitation
Left bundle branch block

4

Prosthetic heart sounds

Mitral valve- loud ‘opening snap’ occurs after S2
Aortic valve- loud S2, ejection click after S1, ejection systolic murmur

5

3rd heart sound

Heart failure
Gallop rhythm
Can be innocent under 30

6

4th heart sound

Before the first heart sound
Abnormal opening of mitral and/or tricuspid which open as atria are contracting
Can’t occur in AF
Ventricular hypertrophy, arrhythmias, coronary heart disease, heart block

7

Aortic stenosis

Calcification, congenital, rheumatic
Chest pain, heart failure, syncope
Angina, dizziness, SoB on exertion
Loud ejection systolic murmur, ‘crescendo-decrescendo’
Radiates to carotids

8

Aortic regurgitation

Bicuspid valve, rheumatic fever, infective endocarditis
SLE, Marfan’s, advanced syphilis, ankylosing spondylitis, aortic dissection
Low diastolic pressure
Early diastolic, soft S1, not well transmitted to carotids

9

Mitral stenosis

Pulmonary hypertension
Rheumatic fever, calcification, SLE, rheumatoid arthritis, carcinoid syndrome, infective endocarditis
SoB on exertion, orthopnoea, paroxysmal nocturnal dyspnoea
AF, systemic emboli, haemoptysis
Mid-late diastolic murmur

10

Mitral regurgitation

Primary- degenerative valvular disease, infective endocarditis
Secondary- Distortion of LV
Pulmonary oedema
Pansystolic murmur