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Medicine > Heart murmurs > Flashcards

Heart murmurs Flashcards

1
Q

What is the character of a mitral stenosis murmur? (4)

A

Mid diastolic
Low pitched
Rumbing (due to low velocity)
Loud S1 due to thick valves requiring large systolic force to shut

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2
Q

Where is the murmur of mitral stenosis best heard?

A

Apex in left lateral position

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3
Q

Is the murmur of mitral stenosis loudest on inspiration or expiration?

A

Expiration

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4
Q

Is the murmur of mitral stenosis best heard with the bell or the diaphragm?

A

Bell

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5
Q

What are possible symptoms of mitral stenosis? (4)

A
  1. Dyspnoea
  2. Fatigue
  3. Haemoptysis
  4. Chest pain
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6
Q

What clinical signs are associated with mitral stenosis? (4)

A
  1. Malar flush (backpressure into pulmonary system, causing rise in CO2 and vasodilation
  2. Palpable tapping apex beat
  3. Signs of pulmonary hypertension (RV heave, loud P2)
  4. Atrial fibrillation - left atrial struggling to push blood through stenotic valve causing disruption to electrical signals resulting in fibrillation
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7
Q

What is the most common cause of mitral stenosis?

A

Rheumatic heart disease

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8
Q

What is the character of a mitral regurgitation murmur? (2)

A

Pan-systolic murmur (throughout systolic period)

High pitched whistling (due to high velocity of blood flow through leaky valve)

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9
Q

Where is the murmur of mitral regurgitation best heard?

A

Apex

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10
Q

Is the murmur of mitral stenosis loudest on inspiration or expiration?

A

Expiration

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11
Q

Where does the murmur of mitral regurgitation radiate?

A

Left axilla

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12
Q

What are possible symptoms of mitral regurgitation? (5)

A
  1. Dyspnoea
  2. Orthopnoea
  3. Paroxysmal nocturnal dyspnoea
  4. Fatigue
  5. Palpitations
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13
Q

What are clinical signs of mitral regurgitation? (4)

A
  1. Atrial fibrillation
  2. Displaced thrusting apex
  3. Signs of pulmonary hypertension (RV heave, loud P2)
  4. Signs of LVF (S3, pulmonary oedema)
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14
Q

What causes mitral regurgitation? (5)

A
  1. Idiopathic weaking with age
  2. Ischaemic heart disease
  3. Infective endocarditis
  4. Rheumatic heart disease
  5. Connective tissue disorders e.g. Ehlers-Danlos Syndrome or Marfan Syndrome
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15
Q

What is the character of an aortic stenosis murmur? (3)

A

Ejection systolic murmur
High pitched murmur
Crescendo-decrescendo

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16
Q

Where is the murmur of aortic stenosis best heard?

A

Upper right sternal edge

17
Q

Where does the murmur of aortic stenosis radiate?

A

Carotids and apex

18
Q

Is the murmur of aortic stenosis loudest on inspiration or expiration?

A

Expiration

19
Q

What are possible symptoms of aortic stenosis? (3)

A
  1. Exertional dyspnoea
  2. Exertional syncope
  3. Angina (coronary perfusion impaired)
20
Q

What clinical signs are associated with aortic stenosis? (4)

A
  1. Slow rising pulse
  2. Narrow pulse pressure
  3. Heaving apex beat
  4. Possibly signs of LVF (S3, pulmonary oedema)
21
Q

What causes aortic stenosis? (4)

A

What causes aortic stenosis?

  1. Idiopathic age-related calcification
  2. Rheumatic heart disease
  3. Bicuspid aortic value (e.g. Turner’s syndrome)
  4. Congenital
22
Q

What is the character of an aortic regurgitation murmur? (2)

A

Early diastolic

Soft (sounds like a breath)

23
Q

What is the murmur of aortic regurgitation best heard?

A

Upper right sternal edge or lower left sternal edge when sitting forwards

24
Q

Is the murmur of aortic regurgitation loudest on inspiration or expiration?

A

Expiration

25
Q

What are possible symptoms of aortic regurgitation? (3)

A
  1. Fatigue
  2. SOB
  3. Palpitations
26
Q

What clinical signs are associated with aortic regurgitation?

A
  1. Collapsing Pulse
  2. Wide pulse pressure
  3. Very displaced thrusting apex
  4. ? Austin Flint murmur (apical early diastolic rumbling)
  5. Signs of heart failure
  6. Signs of backflow (Corrigan’s (visable pulsation), de Musset’s (head-nodding pulse), Quincke’s (red-coloured pulsation in nails)
27
Q

What causes aortic regurgitation? (6)

A

What causes aortic regurgitation?

  1. Idiopathic age-related weakness
  2. Connective tissue disorders e.g. Ehlers-Danlos Syndrome or Marfan Syndrome
  3. Infective endocarditis
  4. Aortic dissection
  5. Rheumatic heart disease
  6. Longstanding hypertension

Medicine (4 decks)

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