CV History & Examination

Question 1

Murmur intensity: grades 1-6

Answer 1

Grade 1: barely audible
Grade 2: audible
Grade 3: loud, no thrill
Grade 4: loud, palpable thrill
Grade 5: heard with stethoscope barely touching skin, palpable thrill
Grade 6: heard with stethoscope off skin, palpable thrill

Question 2

Murmur types.

a) Aortic stenosis
b) Mitral regurgitation
c) Aortic regurgitation
d) Mitral stenosis
e) Inspiration/expiration effects

Answer 2

a) Ejection systolic, crescendo-decrescendo (when critical - cannot hear S2)
b) Pansystolic, blowing
c) Early diastolic (think ‘ARMS’)
d) Mid-diastolic (Mid = mitral)
e) RILE: right inspiration, left expiration

Question 3

Angina: ECG changes

Answer 3

• Pathological Q waves.
• Left bundle branch block (LBBB).
• ST-segment and T-wave abnormalities (eg, flattening or inversion).