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Cardiology Clinical Skills > Auscultation of the heart > Flashcards

Auscultation of the heart Flashcards

Heart sounds and murmurs

1
Q

Describe the 1st heart sound

A

Mitral and tricuspid valves closing. Normal

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2
Q

Causes of a loud 1st heart sound

A

Hyperdynamic blood flow, moderate mitral stenosis

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3
Q

Describe 2nd heart sound

A

Aortic and pulmanory valves closing. Normal

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4
Q

Causes of a soft 1st heart sound

A

Obestity, emphysema, heart failure

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5
Q

Why does physiological splitting of the 2nd heart sound occur?

A

On inspiration the intrathoracic pressure decreases which will increase the venous return of the heart. This will increase the volume in the right ventricle and increase the ejection time. The pulmanory valve will shut after the aortic valve causing the splitting

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6
Q

Describe 3rd heart sound

A

Early diastolic low frequency filling sound. Immediately after the 2nd heart sound. Pathological or normal

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7
Q

Where is the 3rd heart sound best heard?

A

Apex beat with bell

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8
Q

Why does 3rd heart sound happen?

A

Decceleration and acceleration of blood that is passively filling into the ventricles

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9
Q

Causes of 3rd heart sound

A

Left ventricular dysfunction, heart failure

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10
Q

Descibe the 4th heart sound

A

Late diastolic low frequency filing sound. Immediately before the 1st. Pathological

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11
Q

Where is the 4th heart sound best heard?

A

Apex beat with bell

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12
Q

Causes of 4th heart sound

A

Hypertension, aortic stenosis, LVH, myocardial ischaemia

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13
Q

Why does 4th sound occur?

A

Filling of blood into a non cmplaince or stiff ventricle

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14
Q

How must murmurs be desribed?

A

Intensity, character, timing, location, radiation

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15
Q

Describe an innocent murmur

A

Soft, mid diastolic murmur

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16
Q

Where is innocent murmur heard?

A

Pulmanory area

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17
Q

Does innocent murmur radiate?

A

Localised, no radiation

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18
Q

What causes innocent murmur?

A

Hyperdynamic blood (pregnancy, thing, anaemia, young, fever, thyrotoxicosis), NORMAL

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19
Q

Why do innocent murmurs occur?

A

Turbulence of blood in right ventricular outflow tract

20
Q

Mitral regurgitation occurs when?

21
Q

Aortic regurgitation occurs when?

22
Q

Mitral stenosis occurs when?

23
Q

Aortic stenosis occurs when?

24
Q

Describe the murmur heard in aortic stenosis

A

Ejection systolic murmur that radiates to the carotids

25
What is the apex like in aortic stenosis?
Forceful and displaces
26
What are the assosiated symptoms of aortic stenosis
Breathlessness, syncope, chest pain
27
What ECG changes may be seen in a patient with aortic stenosis?
Left axis deviation due to LVH. Causes chest pain as well due to mismathc between supply and demand
28
What would a pressure probe graph look like with aortic stenosis?
High peak pressure before the valve comapred to after
29
How to treat aortic stenosis?
Valve replacement, balloon therapy
30
Describe a mitral regurgitation murmur
Pansystolic murmur that radiates to the axilla
31
Apex beat in mitra regurgitation
Displaced
32
Causes of mitral regurgitation
Rheumatic fever, prolapse, Chordiae or papilla muscle rupture, endocarditis, myxomatous
33
Treatment of mitral regurgitation
ACEI, diuretics, Surgical repair and replacement
34
Assosiated symptoms of mitral regurgitation
Breathlessness, fatigue, peripheral oedema
35
Describe a mitral stenosis murmur
Mid diastolic rumbling murmur. Localised in apex
36
Apex of mitral stenosis
Tapping apex
37
Assosiated symptoms of mitral stenosis
Malar flush, breathlessness, fatigue, palpitations, AF!
38
What could the Xray look like in a patietn with mitral stenosis?
Straight left heart border
39
Causes of mitral stenosis
Rheumatic, rarely congenital
40
Treatment of mitral stenosis
Diuretics, treat the AF, Surgery, ballon dilation
41
What two heart valve defects may lead to cardiomegaly?
Aortic and mitral regurgitation
42
Describe aortic reguritation
Early diastolic murmur. Localised to left sternal edge
43
Apex in aortic regurgitation
Displaced
44
Causes of aortic regurgitationn
Endocarditis, connective tissue diseases, rheumatic, Marfans, aortic dissection
45
Assosiated symptoms and signs of aortic regurgitation
Breathless, collapsing pulse, pulse pulse pressure
46
Treatment of aortic regurgitation
ACEI, Surgery

Cardiology Clinical Skills (1 decks)

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