Cardio

Question 1

Murmur in aortic stenosis

Answer 1

Ejection systolic - mid-to-late peaking. Best heard in aortic area, radiates to carotids, increased w increased stroke volume eg squatting, decreased w decreased SV eg valsalva

Question 2

Murmur in pulmonary stenosis

Answer 2

Ejection systolic - crescendo-decresendo. Best heard in pulmonary area - increases with inspiration

Question 3

Murmur in mitral regurg

Answer 3

Pan-systolic - flat. Best heard at apex, radiates to L axilla

Question 4

Murmur in tricuspid regurg

Answer 4

Pan-systolic - flat. Best heard in tricuspid area, increases with inspiration

Question 5

Murmur in VSD

Answer 5

Pansystolic, flat - 4th-6th intercostal space on L and R sternal edge

Question 6

Murmur in aortic regurg

Answer 6

Early diastolic decrescendo. Heard best at L sternal edge (pulmonary not aortic AHH! (AR) )

Question 7

Murmur in pulmonary regurg

Answer 7

Early diastolic decresendo. Best heard pulmonary area, increased with inspiration

Question 8

Murmur in mitral stenosis

Answer 8

Mid-to-late diastolic decresendo. best heard mitral area with bell in L lateral decubitus position

Question 9

Murmur in tricuspid stenosis

Answer 9

Mid-to-late diastolic crescendo-decresendo. Best heard tricuspid area

Question 10

Murmur in PDA

Answer 10

‘machinery murmur’ in systole and diastole (continuous) heard in left upper chest

Question 11

Aetiology of aortic stenosis

Answer 11

Congenital - bicuspid aortic valve

Acquired - calcification (w age, MC +++), rheumatic fever (uncommon, much more commonly affects mitral valve)

Question 12

Aetiology of mitral regurg

Answer 12

Primary - mitral valve prolapse, age-related mitral calcification, rheumatic fever, infective endocarditis
Secondary - CAD or MI, dilated cardiomyopathy, LHF

Question 13

Management of acute pericarditis

Answer 13

Restricted physical activity for 3/12
Colchicine 500 micrograms BD for 3 months
NSAIDs or Aspirin for 2-4 weeks