Cardiac Lesions

Question 1

features of IHD/CABG
normal pulse/AF
normal BP/narrow pulse pressure
normal venous pulse
displaced apex
sustained impulse
pansystolic murmur to axilla
enhanced end expiration
louder with valsalva

Answer 1

Mitral Regurgitation

Question 2

decreased A2; high-pitched, late-peaking murmur; diminished and delayed carotid upstroke; radiation of murmur to both clavicles and carotids

Answer 2

Aortic Stenosis

Question 3

Diastolic; decrescendo, Enlarged, displaced apical impulse; S3 or S4; increased pulse pressure; bounding carotid and peripheral pulses

Answer 3

Aortic Regurgitation

Question 4

Systolic click in mitral valve prolapse; S3; apical impulse hyperdynamic and may be displaced if dilated left ventricle; in mitral valve prolapse, Valsalva maneuver moves onset of clicks and murmur closer to S1; handgrip maneuver increases murmur intensity

Answer 4

MR

Question 5

Jugular V and C waves

Right ventricular impulse below sternum

Pulsatile, enlarged liver with possible ascites

Murmur may be high-pitched if associated with severe pulmonary hypertension

Answer 5

severe TR

Question 6

Diastolic; low-pitched, decrescendo; increased intensity during inspiration

Answer 6

TS

Question 7

Systolic; crescendo-decrescendo
Left clavicle

Pulmonic ejection click after S1 (diminishes with inspiration)

Answer 7

PS

Question 8

Palpable thrill; Pansystolic murmur increases with handgrip maneuver
Pulmonary hypertension and cyanosis in late stages

Answer 8

VSD