Cardiology

Question 1

What type of murmur(s) is/are heard with an ASD? Why?

Answer 1

1. systolic ejection murmur heard at the LUSB d/t turbulent flow into the pulmonary artery (ASD allows blood from LA to RA, increasing pressure in RA/RV, and increasing flow to pulmonary arteries)
2. diastolic murmur d/t turbulent flow b/w RA and RV d/t from from LA to RA causing more volume in RA and more flow from RA to RV

Question 2

With an ASD, aside from a murmur, what other abnormal heart sound can be heard? Why?

Answer 2

• ABNORMAL SOUND: fixed split S2 (RARE!)
• WHY: persistent increased flow through pulmonic valve (instead of normally changing based on inspiration and expiration)
  
  • NORMAL: during inspiration, A2 and P2 are not synchronized, and so the sound is split; this is due to increased venous return on the right side of the heart causing a delay in closure of the pulmonic valve; during expiration, split S2 is normally no longer audible
  • ABNORMAL: during expiration, RA pressure decreases (less venous return), so blood flows from LA to RA, resulting in increased flow through pulmonic valvue

Question 3

What syndromes are commonly associated with an ASD?

Answer 3

• FAS: fetal alcohol syndrome
• Down Syndrome

Question 4

ACYANOTIC or CYANOTIC:

ASD

Answer 4

acyanotic