Final Exam Auscultations

Question 1

MVP and maneuvers

Answer 1

Mid-late systolic click from sudden tensing of chordae
Apical systolic murmur
Influenced by stroke volume so certain maneuvers like Vasalva and Amyl Nitrite inhalation can help with diagnosis

Reduce LV volume = reduce LV filling = smaller chamber = less restraint on valve from chordae = click and murmur occurs earlier in ventricular systole (supine to standing, vasalva, amyl nitrate)

Increase LV volume = larger chamber = more restraint on valve from chordae = click and murmur to move toward second heart sound are (standing to supine, standing to squatting)