heart Flashcards
S1 closure of …
mitral and tricuspid
Mitral is on the…
right
tricuspid is on the …
left
S2 closure of…
aortic and pulmonary
Which valve closes first S2….
aortic closes before the pulmonary
Why aortic valve close before the pulmonic
aortic has a higher closing pressure (80) compared to pulmonic (10)
S3 is…
transition from rapid to slow ventricular filling in early diastole
S3 can be normal…
in children
S4 is caused by…
forcible atrial contraction against decreased ventricular compliance
S2 splitting of ASD
FIXED
wide fixed splitting
S2 splitting breathing
VARIABLE
wide variable splitting
expiration closer
inspiration farther apart
abnormal S2 splitting possibilities
- RV overload (ASD)
- RV outflow obstruction, such as pulmonary stenosis
- delayed RV depolarization such as RBBB
Single S2
- missing semilunar valve
- if both valves close with same pressure. pulmonary HTN
- posterior displacement of pulmonary valve
What is paradoxical splitting?
when hear P2 before A2
Causes of paradoxical splitting…
- severe aortic stenosis
2. LBBB
Systolic ejection murmurs occur between
S1 and S2
Systolic ejection murmurs patho
turbulent blood flow due to obstruction across the semilunar valves, outflow tracts or arteries.
Murmur intensifies as more blood flows across the obstruction
cresendo-decresendo
SEM include..
innocent
TOF
pulmonary stenosis
aortic stenosis
Holosystolic
S1 - S2 equal noise
Examples of holosytolic
VSD
mitral and tricuspid regurgitation
Diastolic murmurs
usually abnormal
Early diastolic immediately follow…
S2
examples
1. aortic regurg
2. pulmonic regurg
Mid-diastolic murmurs…
Rumble murmurs increased flow (relative stenosis) through the mitral VSD or the tricuspid ASD
Innocent murmurs are characterized by…
Grade III or less
Otherwise normal exam
no cardiac sx
change in intensity with body position
