heart murmurs 2 Flashcards

stenosis
Terms Definitions
Constrictive pericarditis
pericardial knock.
a decrescendo diastolic
AR, PR
Mitral Regurg
holosystolic, high-pitched, blowing, heard best over apex
Systolic Murmurs
Mitral Valve Regurg
Aortic Stenosis
(also: Pulmonic Stenosis
Tricuspid Valve Regurg
Hypertrophic cardiomyopathy
VSD)
Mitral Stenosis
Diastolic
OPENING SNAP
best heard at APEXLEFT LATERAL DECUBITUSBELL
mitral valve thickens and cannot open sufficiently in diastole
a mid/late systolic
MVP, pap muscle dysfunction
Flow Murmurs
Short systolic murmurs, 1-2/6,loudest at USB, do not radiate to the neck, asymptomatic
More Common - Diastolic or Systolic?
Systolic
Mitral prolapse
mid-systolic click or late systolic murmur. Ass'd w/ panic d/o.
Aortic Regurg-murmur
3 Murmurs-Blowing early diastolic at aorta&LSB-Apical diastolic rumble(Austin Flint. *similar to MS but no opening snap)-Midsystolic flow murmur at base
MC Systolic Murmurs
aortic stenosis, mitral valve regurg
Aortic Regurg
causes a wide pulse pressure in chronic condition
Mitral Valve Prolapse
Late Systolic murmur c midsystolic clickIf symptomatic Atenolol 25mg qd
Aortic Regurgitation
Diastolic
best heard at 2, 3, 4 L ICS
LEANING FORWARDBELL/DIAPHRAGM
aortic valve fails to close completely and blood regurgitates from aorta back into LV
LV volume overload
How do I differentiate between the systolic murmurs of AS and MR?
AS is diamond-shaped (crescendo-decrescendo), heard best at the base and radiates to the carotids.MR is holosystolic, heard at the apex and radiates to the axilla
MCC of Mitral Valve Regurg
CHF, MIs, M valve prolapse, Rheumatic fever, endocarditis
what are holosystolic murmurs also known as? what are they caused by
pansystolic murmurs caused by flow from high pressure area to much lower pressure area ... ventricle to atria or left ventricle to right ventricle
VSD
holosystolic, harsh-sounding, loudest at tricuspid area
Tricuspid Regurg
holosystolic, high-pitched, blowing, heard best over tricuspid area c radiation to right sternal border
-LL sternal border
-midsystolic
- louder w/valsalva maneuver
Hypertrophic cardiomyopathy
PDA
occurs secondary to congenital rubella or premature delivery
Aortic Stenosis
Mid-systolic
best heard at aortic region (R 2nd ICS)LEANING FORWARDBELL
may cause pathological split in S2 (P2, A2)
may also heard S4 (decreased compliance)
turbulent flow through A2
increased ventricular afterload
Mitral Regurg-murmur
High pitched apical blowing holosystolic murmur that radiates to axillaLaterally placed PMI, systolic thrill
MCC Tricuspid Regurg
R sided endocarditis (IVDA)
a holosystolic could be what
MR, TR, VSD
-base to clavicles (loudest) to carotids
-midsystolic
-cres-decres
-softer on hand grip (increases periph resistance)
Aortic Stenosis
MCC of VSD
congenital, trauma, complication of cardiac catheterization (rare)
Ventricular septal defect
holosystolic murmur next to sternum. MOST COMMON CONGENITAL HEART DEFECT.
-found at apex, no radiation
-hear best w/patient in L lateral decubitous position
-increases w/exercise
-low pitch
-late diastolic
Mitral Valve Stenosis
MItral Stenosis-rx
B-blocker to slow HRLasix 40 mg to dec pulm edema*Don't give positive inotropic agents
What are the key causes of diastolic murmurs?
1. Aortic regurgitation2. Mitral stenosis
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