Abnormal Heart Sounds Flashcards

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1
Q

When will you hear A2 with increased intensity? P2?

A
  1. systemic HTN
  2. pulmonary HTN, dilated pulmonary a., ASD
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2
Q

When will you hear A2 with decreased intensity or absent? P2?

A
  1. calcific aortic stenosis due to valve immobility
  2. increased AP diameter of chest assoicated with aging; pulmonic stenosis
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3
Q

What is the cause of wide splitting of S2? fixed splitting? paradoxical or reversed splitting?

A
  1. delayed closure of pulmonic valve or early closer of aortic valve
  2. prolonged RV systole or RV failure
  3. LBBB
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4
Q

What are causes of left sided S4?

A
  • hypertensive HD
  • AS
  • ischemic and hypertrophic cardiomyopathy
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5
Q

Tips to ID heart murmurs

A

Look for: timing, location, grade, character, associations

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6
Q

Describe Heart Murmur Grades

A
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7
Q

How does squatting/valsalva affect: MVP, HCM, and AS?

A
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8
Q

What can cause a loud aortic component of S2? soft? loud pulmonary?

A
  1. Systemic HTN, dilated aortic root
  2. Calcific aortic stenosis
  3. Pulmonary HTN
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9
Q

What is the most common innocent murmur in kids aged 1-14?

A

Still’s murmur

*systolic murmur with maximum intensity at the left lower sternal border or between the left lower sternal border and apex and has minimal radiation. The murmur has a characteristic vibratory or musical quality, is louder in the supine than sitting position, is louder in hyperdynamic states (fever, anxiety), and usually is grade 1 or grade 2 in intensity. This murmur usually resolves by early adolescence, if not sooner.

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10
Q

What do you see in murmurs discovered within first six hours of life? after six hours?

A
  1. valve problem - either regurgitation (tricuspid valve or mitral valve) or stenosis (aortic valve or pulmonary valve)
  2. valve pathology or shunt lesions that appear as pulmonary vascular resistance falls (atrial and ventricular septal defects, patent ductus arteriosus, peripheral pulmonary stenosis).
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11
Q

What is a cervical venous hum?

A
  • innocent murmur in children
  • louder when the patient is sitting with head extended
  • softer or absent with rotation or flexion of the head or applying light pressure over the jugular vein when the patient is sitting, or when the patient is supine
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12
Q

What is the most common congenital heart lesion?

A

Bicuspid aortic valve

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