CVPR Week 3: Listening to heart murmurs Flashcards
What causes heart murmurs?
Turbulent flow
Turbulent flow
Forward flow
Backward flow
Shunt from left side circulation to right side or vice versa
![](https://s3.amazonaws.com/brainscape-prod/system/cm/272/498/362/a_image_thumb.jpg?1553892737)
What determines how loud a murmur is?
2 listed
- Degree of turbulence
- Shape and thickness of the chest wall
What determines the length of time a murmur can be heard?
Length proportional to the duration of turbulence
How do we describe murmurs?
5 listed
- Timing *systole vs diastole)
- Intensity
- Location
- Radiation
- Frequency (pitch)
- Related to velocity
- Stethoscope to help distinguish frequencies
Stethoscope: Bell for?
Low frequencies
Stethoscope: Diaphragm for?
high frequencies
Grading of heart murmurs
![](https://s3.amazonaws.com/brainscape-prod/system/cm/272/499/170/a_image_thumb.jpg?1553892953)
Grade 1 Heart Murmur
Very faint
not always heard in all positions
Grade 2 Heart Murmur
quiet but not difficult to hear
Grade 3 Heart Murmur
moderately loud
Grade 4 Heart Murmur
Loud +/- thrills
Grade 5 Heart Murmur
- Very loud +/- thrills
- may be heard with stethoscope partly off the chest
Grade 6 Heart Murmur
- may be heard with stethoscope completely off the chest
- +/- thrills
Cardiac Auscultation sites
![](https://s3.amazonaws.com/brainscape-prod/system/cm/272/499/721/a_image_thumb.jpg?1553893142)
Shape of murmurs
- Systolic
- Diastolic
![](https://s3.amazonaws.com/brainscape-prod/system/cm/272/499/796/a_image_thumb.jpg?1553893216)
Evaluating Cardiac Murmurs
9 listed
![](https://s3.amazonaws.com/brainscape-prod/system/cm/272/499/915/a_image_thumb.jpg?1553893240)
Position of murmur
![](https://s3.amazonaws.com/brainscape-prod/system/cm/272/499/962/a_image_thumb.jpg?1553893269)
Position of murmur: Supine
General auscultation and most heart sounds
Position of murmur: Sitting up and leaning forward and holding exhalation
- Aortic stenosis
- aortic regurgitation
- Pericardial rubs
Position of murmur: Left lateral decubitus
S3, S4, Mitral stenosis (using bell of stethoscope)
Position of murmur: Valsalva manoeuver
increases intensity of mitral valve prolapse and hypertrophic cardiomyopathy
decreases intensity of aortic stenosis
Position of murmur: Squating and standing
- increases intensity of aortic stenosis
- Decreases intensity of outflow obstruction in hypertrophic cardiomyopathy
Describe
![](https://s3.amazonaws.com/brainscape-prod/system/cm/272/500/341/q_image_thumb.jpg?1553893464)
Heart sound questions: S1
![](https://s3.amazonaws.com/brainscape-prod/system/cm/272/500/355/q_image_thumb.jpg?1553893489)
S1
C: During isovolumetric contraction
Heart sound questions: S2
![](https://s3.amazonaws.com/brainscape-prod/system/cm/272/500/418/q_image_thumb.jpg?1553893630)
S2
during isovolumetric relaxation
![](https://s3.amazonaws.com/brainscape-prod/system/cm/272/500/418/a_image_thumb.jpg?1553893608)
S3 occurs when?
S4 occurs when?
Pressure-volume loop
![](https://s3.amazonaws.com/brainscape-prod/system/cm/272/500/459/a_image_thumb.jpg?1553893721)
In what phase of the pressure-volume loop is this heart?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/272/500/498/q_image_thumb.png?1553893805)
Isovolumetric relaxation
![](https://s3.amazonaws.com/brainscape-prod/system/cm/272/500/498/a_image_thumb.jpg?1553893816)