Heart Murmurs

Question 1

Explain the cardiac cycle based on the ventricles myocardium and the heart valves (close or open)

Answer 1

1.) Systole: Period of isovolumic contraction (QRS complex)
2.) Systole: Period of ejection, semilunar valves open
3.) Diastole: Semilunar valves close (S2). Period of isovolumic relaxation
4.) Diastole: Passive ventricular filling, AV valves open.
5.) Diastole: Active ventricular Filling.
6.) Back to first step. AV valves close, (S1)

Question 2

Which valves make up S1 and S2?

S3 / S4?

Answer 2

S1: closure of atrioventricular (tricuspid / mitral) valves
S2: closure of semilunar (aortic and pulmonary) valves

S3 in early diastole
S4 in late diastole

Question 3

3. Briefly describe what is a heart murmur

Answer 3

Heart murmurs are abnormal sounds during your heartbeat cycle due to
turbulent blood in or near your heart.

Question 4

Recognize the surface anatomy of where to best auscultate each a specific heart valve

Answer 4

Aortic: 2nd Right intercostal space
Pulmonic: 2nd Left intercostal space
Tricuspid: 4th Left intercostal space
Mitral: 5th left intercostal space (midclavicular)

Question 5

List the main types of heart murmurs accordingly to timing and which are always abnormal

Answer 5

Main types: Systolic Murmurs, Diastolic murmurs (always abnormal), continuous murmurs, innocent murmurs.

Question 6

Types of Systolic Murmurs:

Answer 6

Aortic Stenosis
Pulmonic Stenosis
Mitral regurgitation
Tricuspid regurgitation

Mitral valve prolapse -> causes mitral regurgitation

Stenosis: abnormal narrowing of a passage in body
Regurgitation: Blood flows back through the valves
Prolapse: displacement

Question 7

Types of Diastolic murmurs:

Answer 7

Aortic regurgitation
Pulmonic regurgitation
Mitral stenosis
Tricuspid stenosis

Septal defects are also diastole

Question 8

Identify conditions that can cause or exacerbate an innocent heart murmur

Answer 8

Physical activity or exercise
Pregnancy
Fever
Changes in your heart’s structure (aging or heart surgery)
Anemia/hypoxemia
Hyperthyroidism (Excessive thyroid hormone)

Question 9

Identify individuals with other pathologies that have higher risk of congenital heart diseases

Answer 9

Single gene Defect: Marfan syndrome (condition affects body’s connective tissue)

Other genetic syndromes: Hemifacial microsomia: (half of one side of face underdeveloped)

Question 10

Identify the most common cause of abnormal murmurs in children and in older children

Answer 10

congenital heart disease (CHD)

Question 11

Identify the most common cause of murmur in USA, and worldwide

Answer 11

Worldwide: Rheumatic fever *

USA: Senile calcific aortic stenosis (AS) *
Mitral valve prolapse (MVP) *

Question 12

Recognize the four main concerns when treating patients with medically complex conditions.

Answer 12

Prosthetic cardiac valve
History of infective endocarditis
Congenital heart disease (CHD)
Cardiac transplantation recipients with cardiac valvular disease

Question 13

Identify patients with Low Risk of IE therefore do not need antibiotic prophylaxis

Answer 13

Routine anesthetic injections through noninfected tissue
Taking dental radiographs
Placement of removable prosthodontic or orthodontic
appliances
Adjustment of orthodontic appliances
Placement of orthodontic brackets
Shedding of deciduous teeth
Bleeding from trauma to the lips or oral mucosa

skim through this one. Just get general idea