Cardiovascular

Question 1

Auscultation:

When a murmur is heard between heart sound 1 and 2, what are the possible valve issues?

Answer 1

A systolic murmur - either ejection systolic or pan-systolic

Possible causes:
Aortic stenosis (Ejection) - most common!
Pulmonary stenosis

Mitral regurgitation (pan-systolic)
Tricuspid regurgitation 

Reminder:
HS 1 = M/T valve closure
(closes at start of systole)
HS 2 = A/P valve closure

Question 2

How does AF affect pulse?

Answer 2

Pulse felt will be irregularly irregular.

This is because the atria irregularly send impulses to the ventricles.

The pulse is dependent on left ventricular contraction, so if the ventricle is triggered (doesn’t have to be a full atrial beat that triggers it) early, the pulse felt won’t be regular.