Cardiac Condensed Flashcards
Murmurs
Turbulent blood across the heart valve
S1
MOTIVATED
Systole
Mitral and Tricuspid valves close
S2
APPLES
Aortic and Pulmonic valve is closed
Diastole
S3
Occurs early in diastole
Can be from CHF
called ventricular gallop or kick
Can be normal in children, preg women, some athletes ( once corrected it will go away)
Always abnormal in people over 35
S4
Occurs in late diastole Indicated LVH ( atrial gallop)
Systolic Murmurs
MR. ASS
S1 -S2
Murmurs are louder and can radiate to neck or axilla
Mitral regurgitation
Aortic Stenosis
Mitral regurgitation
Mitral valve not closing properly and blood from L ventricular is pumped back into pulmonary veins
Holosystolic murmur
Heard best at apex
Radiates to axilla
Loud blowing murmur + high pitched ( diaphragm)
Aortic Stenosis
Mid systolic ejection murmur
Best heard at 2nd ICS - radiates to neck
Harsh, noisy murmur
Physical overexertion can lead to sudden death
Obstruction of flow from LV into aorta
Systolic crescendo - decrescendo
LVH
Wide apical pulse
Paradoxical splitting of S2
Mitral Valve Prolapse
Mid to late systole
Mid systolic click
When mitral valve leaflets bulge back into the left atrium — can lead to MR
W> M - can be missed dx as anxiety
How to differiente between AS and MR
Sustained hand grip increases vascular resistance and afterload
MR = increased sounds AS = Decreased sounds
Maneuver to accentuate AS
Valsalva and standing - decreased sounds
Diastolic mumurs
MS. ARD
S2
Always indicative of heart disease
Mitral stenosis
Mid diastolic rumbling murmur
Heard loudest at apex when pt lying on LEFT side
often a Opening Snap = bell = calcified valve
Pulmonary HTN can be caused by MS and R heart failure
Aortic Regurgitation
incomplete closure of aortic valve . Blood from aorta into L ventricular
High pitched diastolic murmur ( blowing ) ( diaphragm )
Best heard 2 ICS
Decrescendo
May be heard w/ S3
Manuevers to accentuate AR
Squatting and hand grip = increased sound
Sitting upright and forward = increased sound
