Heart Murmurs

Question 1

MR/TR characteristic sound

Answer 1

Holosystolic high-pitched blowing

Question 2

MR is loudest and radiates where

Answer 2

Loudest at Apex

Radiates to axilla

Question 3

TR is loudest and radiates where

Answer 3

Loudest at Tricuspid area

Radiates to Right Sternal Border

Question 4

What enhances MR

Answer 4

↑ TPR (Squatting, Hand grip)

Question 5

What enhances TR

Answer 5

↑ RA return (Inspiration)

Question 6

Major causes of MR

Answer 6

Ischemic heart disease
MVP
LV dilation

Question 7

Major causes of TR

Answer 7

Rheumatic fever
Infective endocarditis
(Both can also cause MR)

Question 8

AS characteristic sound

Answer 8

Crescendo-Decrescendo

Question 9

AS is loudest and radiates where

Answer 9

Loudest at heart base

Radiates to carotids

Question 10

AS pulses

Answer 10

Pulsus parvus et tardus (weak and delayed)

Question 11

End results of AS

Answer 11

Syncope
Angina
Dyspnea

Question 12

Causes of AS

Answer 12

Calcific aortic stenosis
Bicuspid aortic valve
Rheumatic valve disease
Congenital unicuspid valve disease
Syphilis

Question 13

VSD characteristic sound

Answer 13

Holosystolic, harsh

Question 14

VSD loudest where

Answer 14

Loudest at Tricuspid area

Question 15

What enhances VSD murmur

Answer 15

Hand grip

Question 16

MVP characteristic sound

Answer 16

Late systolic crescendo with midsystolic click

Question 17

What is the most frequent valvular lesion

Answer 17

MVP

Question 18

MVP loudest where

Answer 18

Over apex just before S2

Question 19

Causes of MVP

Answer 19

Myxomatous degeneration
Rheumatic fever
Chordae rupture

Question 20

AR/PR characteristic sound

Answer 20

High-pitched blowing early diastoic decrescendo

Question 21

What happens with chronic AR

Answer 21

Wide pulse pressure

Question 22

How does AR present

Answer 22

Bounding pulses

Head bobbing

Question 23

What causes AR

Answer 23

Aortic root dilation
Bicuspid aortic valve
Endocarditis
Rheumatic fever
Syphilis
Marfan

Question 24

What increases AR

Answer 24

Hand grip

Question 25

What decreases AR

Answer 25

Vasodilators

Question 26

MS/TS characteristic sound

Answer 26

Opening snap

Delayed rumbling late diastolic murmur

Question 27

How do you know MS is severe

Answer 27

Decreased interval between S2 and opening snap

Question 28

What causes MS

Answer 28

Secondary to Rheumatic fever

Question 29

What enhances MS

Answer 29

↑ LA return (Expiration)

Question 30

PDA characteristic sound

Answer 30

Continuous machine-like murmur

Question 31

When is PDA loudest

Answer 31

S2

Question 32

Where is PDA best heard

Answer 32

Left infraclavicular area