Heart mumurs Flashcards
MR/TR
Holosystolic, high pitched blowing murmur
Rheumatic fever and infective endocarditis can cause either MR or TR
MR loudest when
Mitral: loudest at apex and radiates toward axilla, enhanced by maneuvers that increase TPR (squatting, hand grip) or LA return (expiration)
TR loudest when
Tricuspid: loudest at tricuspid and radiates to right sternal border, enhanced by maneuvers that increase RA return (inspiration)
Aortic stenosis
Crescendo-decrescendo systolic ejection following ejection click (due to abrupt halting of valve leaftlets).
LV» aortic pressure during systole
Radiates to carotid and heart bases.
AS consequences
Pulsus parvus et tardus: pulses are weak with a delayed peak.
Syncope, angina, and dyspnea on exertion (SAD)
VSD
Holosystolic harsh-sounding murmur
VSD loudested when
Loudest at tricuspid area, accentuated with hand grip maneuver due to increased afterload.
Mitral valve prolapse
Late systolic crescendo with midsystolic click.
Can predispose you to infective endocarditis.
Can be cuased by myxomatous degeneration, rheumatic fever, or chordae rupture.
MVP loudest when
Best heart over apex, loudest at S2.
Enhanced by maneuvers that decrease venous return (standing or valsalva)
Heart murmurs:
systolic
1) MR/TR
2) AS
3) VSD
4) MVP
AR
High pitched blowing diastolic decrescendo
While pulse pressure when chronic;
presents with bounding pulses and head bobbing.
Due to aortic root dilation, bicuspid aortic valve, endocarditis, or rhuematic fever.
AR sound change
Increase with hand grip
Decrease with vasodilator
MS
Follows opening snap,
delayed rumbling late diastolic murmur;
LA»V pressure during diastole
Often 2/2 rheumatic fever.
Chronic MS leas to LA dilation
MS loudest when
Maneuvers that increase LA return (expiration)
Diastolic murmurs
AR and MS
