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Flashcards in Murmurs Deck (10):

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


Splitting of S2

Wide fixed splitting in atrial septal defect


Soft heart sounds

Severe mitral regurgitation
Severe aortic regurgitation
Left bundle branch block


Prosthetic heart sounds

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


3rd heart sound

Heart failure
Gallop rhythm
Can be innocent under 30


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


Aortic stenosis

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


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


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


Mitral regurgitation

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