Heart Murmurs Flashcards
Crescendo-decrescendo murmur heard best at the right second intercostal space with radiation to the carotids
Aortic Stenosis
Holosystolic murmur heard best at the cardiac apex with radiation to the axilla
Mitral regurgitation
Midsystolic click + Holosystolic murmur heard best at the cardiac apex with radiation to the axilla
Mitral valve prolapse
Harsh holosystolic murmur at the left sternal border
Ventricular septal defect
“Decrescendo murmur at the right or left second intercostal space”
Aortic regurgitation
Opening snap with diastolic rumble heard best at the cardiac apex
Mitral stenosis
“plop with diastolic rumble”
Atrial Myoxma
“Continuous machine-like murmur”
patent ductus arteriosis
Wide FIXED splitting
atrial septal defect
Name two reasons for wide splitting
- pulmonary stenosis
2. Right bundle branch block
Name two reasons for paradoxical splitting
- Left bundle branch block
2. aortic stenosis
When does an S3 occur and why?
Right after S2. Due to volume excess
Name reasons for S3
Eccentric hypertrophy (back flow, dilated cardiomyopathy), RAAS over-activation (fluid overload) normal in children, athletes and pregnant women
When does an S4 occur and why?
It occurs right before S1 and represents pressure excess
Name reasons for S4
concentric hypertrophy, stiffening of LV wall,
chronically increased afterload due to hypertension, aortic stenosis, HOCM
Which maneuvers DECREASE preload? (2)
Valsalva, standing,
Which maneuvers INCREASE preload? (2)
passive leg raise, squatting
Which maneuvers INCREASE afterload?
handgrip, rapid squatting
Name 7 causes of systolic mumurs
Aortic stenosis Pulmonary stenosis Mitral regurgitation Tricuspid regurgitation, VSD HOCM mitral valve prolapse
Name 3 causes of diastolic murmurs?
aortic regurgitation
mitral stenosis
atrial myoxma
What would happen to aortic stenosis murmur during standing?
Decrease in intensity due to decreased preload (less blood flow through stenotic vessel)
What would happen to aortic stenosis murmur during handgrip?
Decrease in intensity because you have less flow (less turbulence) so quieter murmur
What would happen to aortic stenosis murmur if you administered fluids
Increase in intensity because of increased preload
What would happen to mitral regurgitation murmur if you raised your legs?
Increased intensity of the murmur because increased preload means more backflow
