Murmurs Flashcards
(15 cards)
What causes S1
Closing of AV valves: mitral and tricuspid
At beginning of systolic contraction
What causes S2
Closure of semilunar valves: Pulmonary and aortic
Once systolic contraction is complete
S3?
0.1 s after the S2
Rapid ventricular filling- causes the ventricles of the heart to pull towards them.
what does S3 indicate in the young and the old?
In the young? normal
In the elderly? can be a sign of HF
What is S4?
Heart before s1 - ALWAYS ABNORMAL
stiff or hypertrophic ventricle
due to an atria contracting against a ventricle which is non compliant
Where are the different vales located?
Aortic: second intercostal on right side of sternum
Pulmonary: second intercostal on left side of sternum
Tricupsid: 5th intercostal and LLSB
Mitral: 5th intercostal- midclavicular line
What is Erb’s point
Best point for listening to heart sounds
Located in 3rd intercostal LSB
How to describe a murmur
SCRIPT site character Radiation Intensity Pitch: high? low and grumbling? Timing- systolic/diastolic
What consequences can valvular disease have?
- Hypertrophy - when muscle has to contract more against a constriction
- Dilatation: when there is a leaky valve- more blood flowing into the ventricle/atrium
Mitral stenosis aetiology
- Rheumatic Heart disease
- Endocarditis
Mitral stenosis murmur and presentation
Murmur
- Mid diastolic
- Low pitched
- Rumbling
+ loud S1
Palpable apex beat
Malar flush- due to blood being pushed back into the pulmonary system
AF
Mitral regurgitation
Pan systolic murmur
High pitched
Radiates to left axilla
Aetiology of MR
- Age
- ISH
- Endocarditis
Aortic stenosis
- Ejection systolic murmur
- Crescendo/ decrescendo murmur
- Radiates to carotids
- slow to rise pulse
- Exertional syncope: due to difficulties maintaining blood to the brain to meet requirements
Aortic regurgitation
- Early Diastolic murmur
- Collapsing pulse
- Can lead to HF
