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PCM III - Exam 1 > Abnormal Heart Sounds > Flashcards

Abnormal Heart Sounds Flashcards

1
Q

S3 heart sound

A

Occurs from limited rapid filling phase of diastole

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2
Q

S4 heart sound

A

Occurs during systole and a wave of atrial pulse pressure

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3
Q

S1 heart sound

A

Closure of mitral valve

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4
Q

S2 heart sound

A

Closure of aortic valve

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5
Q

Split S2 listening post

A

Best heard between the 2nd and 3rd intercostal space

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6
Q

Timing of S2 split

A

Best heard during late inspiration

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7
Q

A2 with increased intensity

A

Occurs in systemic hypertension due to increased preload

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8
Q

A2 decreased or absent

A

Calcific aortic stenosis du to immobility

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9
Q

P2 with increased intensity

A

Suspect Pulmonary HTN
Dilated cardiomyopathy
ASD

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10
Q

P2 with decreased intensity

A

Increased AP diameter of the chest associated with aging

Pulmonary stenosis

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11
Q

Causes of delayed closure of pulmonic valve

A

Pulmonic stenosis

RBBB

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12
Q

Causes of early closure of pulmonic valve

A

Mitral regurg

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13
Q

Prolonged right ventricular systole

A

Seen in ASD

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14
Q

Cause of delayed A2 in expiration

A

LBBB

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15
Q

An early systolic sound is from

A

Halting of semilunar valves

A aortic valve can be heard at base and apex

A pulmonic valve heard best at 2/3 L ICS

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16
Q

Opening Snap occurs

A

In early diastole which is caused by a stenotic mitral valve

Should use diaphragm to listen

17
Q

Systolic click cause

A

Mitral valve prolapse

18
Q

Mitral valve prolapse changes with position

A

Squatting delays click

Standing makes click earlier

19
Q

S3 sound cause

A

Normal in athletes <40 y/o and Women in third trimester

Caused by decreased myocardial contractility, heart failure ventricular volume overload from mitral regurg and L-to-R shunting

20
Q

S4 sound cause

A

Low pitched and best heard with bell at the lower left sternal border

Common in athletes and older people

Caused by fibrosis and ventricular hypertrophy

21
Q

Grade 1 Murmur

A

very faint and may not be heard at all positions

22
Q

Grade 2 Murmur

A

Quite but heard immediately when stethoscope is placed on chest

23
Q

Grade 3 Murmur

A

Moderately loud

24
Q

Grade 4 Murmur

A

Loud with a palpable thrill

25
Q

Grade 5 Murmur

A

Very loud with a thrill even with stethoscope barely on chest

26
Q

Grade 6 Murmur

A

Can be heard without stethoscope

27
Q

Aortic Stenosis

A

Best heard at 2nd & 3rd R ICS

Radiates up carotid and down left sternal border

Harsh, crescendo-decrescendo

Best heard sitting and leaning forward

28
Q

Hypertrophic Cardiomyopathy

A

Best heard at 3rd & 4th L ICS

Radiates down left sternal border to apex

Intensity decreases by squatting and increased by standing

29
Q

Pulmonic Stenosis

A

Best heard at 2nd & 3rd L ICS

Radiates up shoulder and neck

Crescendo-decrescendo

30
Q

Mitral Regurgitation

A

Best heard at Apex

Radiates to left axilla

Harsh, holosystolic

31
Q

Tricuspid Regurgitation

A

Best heard at Lower left sternal border

Radiates right sternal border

Blowing, holosystolic

Increases in intensity with inspiration

32
Q

Ventricular Septal Defect

A

Best heard at 3rd, 4th, 5th L ICS

Intensity depends on size of murmur

High, holosystolic

33
Q

Aortic Regurgitation

A

Best heard at 2nd, 3rd, 4th L ICS

Radiates to apex and to R sternal border

High pitched - use diaphrgam

Blowing decrescendo

Best heard sitting and leaning forward

34
Q

Mitral Stenosis

A

Usually limited to apex

Decrescendo low-pitched - use bell

Best heard at apical impulse and during exhalation

35
Q

Atrial Myxoma

A

Mid-diastolic murmur

LA myxoma can be mistaken w/ mitral stenosis

Presystolic and crescendo

36
Q

Squatting

A

MVP - Delay of click and murmur shortens

Hypertrophic cardiomyopathy - decreases intensity of murmur

Aortic stenosis - increased intensity of murmur

37
Q

Standing

A

MVP - Earlier after S1 of click and murmur

Hypertrophic cardiomyopathy - increases intensity of murmur

Aortic stenosis - decreased intensity of murmur

38
Q

Most common cause of S3 heart sound

A

Congestive heart failure
Dilated cardiomyopathy

Less common
Valvular regurgitation
Left to right shunting

39
Q

Most common cause of S4 heart sound

A

Hypertension
Aortic stenosis
Ischemic or hypertrophic cardiomyopathy

Mitral regurgitation - abrupt onset = ruptured chorda tendinae

PCM III - Exam 1 (1 decks)

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