Cardiovascular: Murmurs Flashcards
Type of murmur for mitral regurgitation
pansystolic
Location of mitral regurgitation
apex
Radiation of mitral regurgitation
to left axilla, less often to left sternal border
Intensity of mitral regurgitation
soft to loud; if loud associated w/ apical thrill
Pitch of mitral regurgitation
medium to high
Quality of mitral regurgitation
harsh, holosystolic
Aids for mitral regurgitation
does not become louder w/ inspiration
Type of murmur for tricuspid regurgitation
pansystolic
Location of tricuspid regurgitation
lower left sternal border
Radiation of tricuspid regurgitation
to the right of sternum, to xiphoid area, & perhaps left midclavicular line, but NOT into axilla
intensity of tricuspid regurgitation
variable
Pitch of tricuspid regurgitation
medium
Quality of tricuspid regurgitation
blowing, holostystolic
Aids for tricuspid regurgitation
intensity may increase slightly w/ inspiration
Type of murmur for ventricular septal defect
pansystolic
Location of ventricular septal defect
3rd, 4th, 5th intercostal spaces
Radiation of ventricular septal defect
of ten
Intensity of ventricular septal defect
often very loud, w/ a thrill
Pitch of ventricular septal defect
high, holosystolic
Quality of ventricular septal defect
often harsh
Type of murmur for innocent/physiologic murmurs
midsystolic
Location of innocent/physiologic murmurs
2nd-4th left interspace between left sternal border & apex
Radiation of innocent/physiologic murmurs
none
Intensity of innocent/physiologic murmurs
grade 1-2, possibly 3
Pitch of innocent/physiologic murmurs
soft to medium
Quality of innocent/physiologic murmurs
variable
Aids for innocent/physiologic murmurs
usually decreases or disappears on sitting
Type of murmur for aortic stenosis
midsystolic
Location of aortic stenosis
right 2nd interspace
Radiation of aortic stenosis
often to carotids, down left sternal border, even to apex
Intensity of aortic stenosis
sometimes soft but often loud w/ a thrill
Pitch of aortic stenosis
medium, hard, crescendo-decrescendo
Quality of aortic stenosis
often hard, may be more musical at apex
Aids for aortic stenosis
heard best w/ patient sitting & leaning forward
Type of murmur for hypertrophic cardiomyopathy
pathologic
Location of hypertrophic cardiomyopathy
3rd-4th left interspace
Radiation of hypertrophic cardiomyopathy
down the left sternal border to the apex, possibly to the base, but NOT to the neck
Intensity of hypertrophic cardiomyopathy
variable
Pitch of hypertrophic cardiomyopathy
medium
Quality of hypertrophic cardiomyopathy
harsh
Aids for hypertrophic cardiomyopathy
decreases w/ squatting, increases w/ straining down from Valsalva & standing
Type of murmur for pulmonic stenosis
pathologic
Location of pulmonic stenosis
2nd-3rd left interspace
Radiation of pulmonic stenosis
if loud, toward the left shoulder & neck
Intensity of pulmonic stenosis
soft to loud; if loud associated w/ thrill
Pitch of pulmonic stenosis
medium, crescendo-decrescendo
Quality of pulmonic stenosis
often harsh
Type of murmur for aortic regurgitation
diastolic
Location for aortic regurgitation
2nd-4th left interspace
Radiation of aortic regurgitation
if loud, to apex, perhaps to right sternal border
Intensity of aortic regurgitation
grade 1-3
Pitch of aortic regurgitation
high, use diaphragm
Quality of aortic regurgitation
blowing, decrescendo, may be mistaken for breath sounds
Aids for aortic regurgitation
heard best w/ patient sitting, leaning forward w/ breath held after exhalation
Type of murmur for mitral stenosis
diastolic
Location of mitral stenosis
usually limited to apex
Radiation of mitral stenosis
little or none
Intensity of mitral stenosis
grade 1-4
Pitch of mitral stenosis
decrescendo, low-pitched rumble, use bell
Aids for mitral stenosis
placing bell exactly on apical impulse, turning patient into left lateral position & mild exercise all help make murmur audible; heard better in exhalation
