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ECOS 2 Post-Midterm > Approach to Cardiac Murmurs > Flashcards

Approach to Cardiac Murmurs Flashcards

1
Q

S1

A

Closure of Mitral and Tricuspid valves

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2
Q

What heart sound marks the beginning of systole?

A

S1

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3
Q

S2

A

Closure of Aortic and Pulmonic valves

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4
Q

What heart sound marks the end of systole?

A

S2

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5
Q

When is S3 heard?

A

After S2

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6
Q

S3

A

Rapid ventricular filling

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7
Q

When is S4 heard?

A

Before S1

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8
Q

S4

A

Atrial contraction against stiff ventricles

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9
Q

When is S3 normal to hear?

A

Children

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10
Q

When is S4 normal to hear?

A

Athletes

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11
Q

What is the order of the phases of the cardiac cycle (7)?

A 
Atrial Contraction
Isovolumetric Contraction
Rapid Ejection
Reduced Ejection
Isovolumetric Relaxation
Rapid Filling
Reduced Filling
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12
Q

Where is the aortic valve heard?

A

Right 2nd ICS near sternum

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13
Q

Where is the pulmonic valve heard?

A

Left 2nd ICS near sternum

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14
Q

Where is Erb’s point?

A

Left 3rd ICS

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15
Q

Where is tricuspid valve heard?

A

Left 4th ICS near sternum

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16
Q

Where is mitral valve heard?

A

Left 5th ICS mid-clavicular line

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17
Q

Where is point of maximal impulse?

A

Left 5th ICS mid-clavicular line

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18
Q

Stenosis

A

Turbulent blood flow through a stiff/narrowed valve

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19
Q

Regurgitation

A

Turbulent blood flow in an opposite direction than normal

20
Q

When are systolic murmurs heard?

A

During Ventricular systole

atrial Diastole

21
Q

When are diastolic murmurs heard?

A

During Atrial systole

ventricular Diastole

22
Q

Do murmurs always indicate there is a problem?

A

NO

23
Q

When do murmurs become a problem?

A

When there are symptoms – get an EKG

24
Q

What 3 things do you note about a murmur?

A

Location
Timing
Shape

25
Q

Crescendo

A

Grows louder

26
Q

Decrescendo

A

Grows softer

27
Q

Cresendo-Decrescendo

A

First gets louder then softer

28
Q

Plateau murmur

A

Same intensity throughout

29
Q

Continuous murmur

A

Begins in systole and continues through diastole but does NOT have to be uniform

30
Q

Patient positioning to better hear aortic regurgitation?

A

Lean forward

31
Q

Patient positioning to better hear mitral stenosis?

A

Left lateral decubitus

32
Q

What murmurs are possible during Ventricular systole?

A

Aortic/Pulmonic Stenosis

Mitral/Tricuspid Regurgitation

33
Q

When will mid-systolic murmurs be heard?

A

After S1 and stops BEFORE S2

34
Q

When will pansystolic murmurs be heard?

A

Starts with S1 and stops AT S2

35
Q

What position will cause aortic stenosis murmurs to be louder?

A

Squat

Valsalva release

36
Q

What position will cause aortic stenosis murmurs to be softer?

A

Standing

Valsalva strain

37
Q

What murmurs are possible during Ventricular diastole?

A

Mitral/Tricuspid Stenosis

Aortic/Pulmonic Regurgitation

38
Q

When are diastolic murmurs heard?

A

Between S2 and S1

39
Q

Inspiration or Expiration, when are right sided murmurs louder?

A

INSPIRATION

40
Q

Inspiration or Expiration, when are left sided murmurs louder?

A

EXPIRATION

41
Q

Normally, as preload and/or afterload INCREASE, what happens to the intensity of murmurs?

A

INCREASE

42
Q

What conditions decrease in intensity as preload and/or afterload INCREASE?

A

Hypertrophic Obstructive Cardiomyopathy (HOCM)

Mitral Valve Prolapse

43
Q

Mid-systolic click

A

Mitral valve prolapse

44
Q

Opening snap

A

Mitral stenosis

45
Q

History of IV drug abuse

A

Tricuspid Regurgitation

46
Q

Blowing murmur after S2

A

Aortic Regurgitation

47
Q

Cresendo-Decrescendo after S1 that radiates up to carotids

A

Aortic Stenosis

ECOS 2 Post-Midterm (6 decks)

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