Cardiac - murmurs Flashcards
1
Q
systolic murmurs (7)
A
Ejection:
- Aortic sclerosis (no radiation)
- Aortic stenosis
Pan:
- Mitral regurgitation
- Mitral prolapse
Other:
- Ventricular septal defect
- Hypertrophic cardiomyopathy (early)
- Innocent
2
Q
Diastolic murmurs
A
Early:
- Aortic regurgitation
- Pulmonic regurgitation
(- LAD artery stenosis??)
Mid: - Mitral stenosis - Tricuspid stenosis - Atrial myxoma ( - Austin-flint and Carey-Coombs murmurs)
3
Q
Continuous murmurs
A
PDA
4
Q
Features of murmurs (5)
A
- Intensity
- Pitch
- Configuration (crescendo etc.)
- Location
- Timing
5
Q
Murmur grading
A
1 - faintest 2 - faint but early identification 3 - moderately loud 4 - associated thrill 5 - not heard without stethoscope 6 - audible without stethoscope
6
Q
Causes of Aortic stenosis:
A
Acquired - Calcification, rheumatic fever
Congenital - Bicuspid valve
7
Q
Causes of Aortic regurgitation:
A
Acute:
- Infective endocarditis
- Type A aortic dissection
Chronic: Congenital - bicuspid aortic valve Rheumatic heart disease connective tissue disorders - marfans, Ehlers Danlos Autoimmune - RA, Ank Spond
8
Q
Signs of A. Stenosis
A
ESM - Radiates to carotids - Loudest sitting forward, end expiration - Muffled A2 Slow rising pulse
9
Q
Signs of A. Regurgitation
A
Corrigans - carotid pulsation De Mussets - head bobbing Quinckes - nail bed pulsation Traubes - pistol shot femorals Austin-flint murmur - MDM = severe AR Duroziezs - murmur over femoral artery with proximal compression EDM - sitting forward, end expiration Collapsing pulse
10
Q
Rheumatic fever bacteria
A
Strep Pyogenes
Group A Beta-strep
11
Q
Causes of M. Stenosis
A
Congenital
Prosthetic valve
Rheumatic fever
12
Q
Signs of M. Stenosis
A
AF and palpitations
Malar flush (ortners syndrome - cardiovocal)
Tapping apex
MDM - Apex, radiates to axilla, graham steele murmur
13
Q
Austin-flint murmur
A
A. regurgitation
14
Q
Graham-Steele murmur
A
PR secondary to M. Stenosis
15
Q
Causes of M. regurgitation
A
M. valve prolapse LV dilation - AR, AS, HTN annular calcification Post-MI - papillary dysfunction Rheumatic fever Connective tissue disorders
