Cardiac Exam Flashcards
Heart Murmurs
Blood turbulance
4 Heart valves -Aortic -Pulmonic Soft murmur -Tricuspid Soft murmur -Mitral
Problems with Valves
Stenotic- Doesn’t open properly. The chamber behind has to work harder- englarges.
Regurgent- Doesn’t close properly, chamber behind and in front englarges.
Redundancy of Leaflets- extra tissue, mitral valve prolapse.
What part of the cardiac cycle do you hear murmur?
Systole-work
Closure of Tricuspid and Mitral valves
Diastole-rest
Closure of Aortic and Pulmonic Valves
Visualize or palpate carotid
Systolic in conjunction with carotid pulse
Characteristics of Murmurs
Timing – Systolic or Diastolic
Location – Apex, LLSB, LSB, Base, throughout precordium
Radiation – Axilla, neck
Pitch – High, Medium, Low
Quality – Blowing, rumbling, harsh or musical
Grading of Systolic Murmurs
Grade I/VI- barely audible
Grade II/VI- audible but soft
Grade III/VI Easily audible
Grade IV/VI- Easily audible and
associated with a thrill
Grade V/VI Easily audible, associated with a thrill, and still heard with the stethoscope only lightly on the chest
Grade VI/VI- Easily audible, associated with a thrill, and still heard with the stethoscope off the chest
Systolic Murmurs
Systolic Murmurs
MR-Mitral Regurgitation
PM-Physiologic Murmur
AS-Aortic Stenosis
MVP-Mitral Valve Prolapse
Diastolic Murmurs
AR- Aortic Regurgitation
MS- Mitral Stenosis
Aortic Stenosis
Systolic Murmur
Valve replacement: ASC- Angina, Syncope, CHF
Narrow pulse pressure 130/110
No ABX for dental procedures
Aortic Regurgitation
Diastolic Murmur Feel heartbeating CP non angina Wide Pulse Pressure Males 3:1 Females
Mitral Stenosis
Diastolic Murmur Rheumatic Fever Need valve replacement Average age 48y without valve replacement Dyspnea, Afib Dental prophylaxis not any more
Mitral Regurgitation
Systolic Murmur Radiates to Axilla Common Systolic CHF, fatigue 40-60, need valve
Mitral Valve Prolapse
Common Palpitations, CP with exercise SVT Young women Caffiene CLICK!
Physiologic murmur disappears with movement
S3
(Slushing in)
Fluid overload
Children and young adults
>40 early indicator of heart disease
S4
(A Stiff Wall) CAD HTN Dilated hypertrophic cardiomyopathy Aortic Stenosis
