Heart Auscultation Flashcards
0
Q
Systolic Ejection Murmur (Crescendo-Decrescendo)
Seen In…?
-> Soft?
- > R 2nd interspace?
- > L 2nd interspace?
- > Holosystolic- L 4th interspace?
- > LOW L sternal border (2, 1st↑with inspiration)?
- > Apex? (Can↑through Systole)
A
- Can be normal in pregnancy, infants + children
- Aortic Stenosis
- Pulmonic Stenosis
- VSD
- Tricuspid Regurg
- Hypertrophic Cardiomyopathy
- Mitral Regurg
1
Q
Diastolic Murmur
Seen In…?
-> Decrescendo- L 2nd interspace?
- > L 4th interspace?
- > Decrescendo- L 4th interspace?
- > Apex?
- > Rumble- Apex? (Austin-Flint Murmur)?
A
- Pulmonic Regurg
- Tricuspid Stenosis
- Aortic Regurg
- Mitral Stenosis
- SEVERE Aortic Regurg
2
Q
Continuous “machine-like” Murmurs
Seen In?
A
SEEN IN:
- PDA (heard at L 2nd intercostal space)
3
Q
Mitral “opening snap”?
A
Mitral Stenosis
4
Q
Systolic Clicks
Seen In…?
- > Early (2)?
- > Changing with position?
A
- Congenital Aortic / Pulm Valve Stenosis
- SEVERE Pulm Htn
- Myxomatous degeneration of Tricuspid / Mitral Valves
5
Q
Diastolic Knock
Seen In?
A
SEEN IN:
- Constricting Pericardium
6
Q
S1
- > Absent / Soft?
- > Loud?
A
- Mitral Regurg (if valve is STIFF)
- Mitral Stenosis
7
Q
S2
-> Single (3 Causes)?
- > Late Aortic Valve Closure?
- > Late Pulmonic Valve Closure (2)?
- > FIXED Split during Resp?
- > PARADOXICAL Split?
A
- BADLY DAMAGED Aortic Valve (atresia, regurg or stenosis)
- L Bundle Branch Block
- R Bundle Branch Block or ASD
- ASD
- L Bundle Branch Block
8
Q
S3
- > Protodiastolic Gallop (3)?
- > Pericardial Knock?
A
- (↑ventricular filling)
- L-to-R Shunt
- Mitral Regurg
- LV Failure
- Dilated + Noncompliant ventricle(s)
- ** Normal in Children ***
9
Q
S4
Seen In?
A
SEEN IN:
- Ventricular dysfunction due to ISCHEMIA / INFARCTION
10
Q
Combined S3 + S4 = Summation Gallop
Seen In?
A
SEEN IN:
- Ventricular dysfunction + Tachycardia
11
Q
“Irregularly irregular pulse”
Seen In?
A
SEEN IN: Atrial Fib
