Heart Murmurs Flashcards
MR/TR characteristic sound
Holosystolic high-pitched blowing
MR is loudest and radiates where
Loudest at Apex
Radiates to axilla
TR is loudest and radiates where
Loudest at Tricuspid area
Radiates to Right Sternal Border
What enhances MR
↑ TPR (Squatting, Hand grip)
What enhances TR
↑ RA return (Inspiration)
Major causes of MR
Ischemic heart disease
MVP
LV dilation
Major causes of TR
Rheumatic fever
Infective endocarditis
(Both can also cause MR)
AS characteristic sound
Crescendo-Decrescendo
AS is loudest and radiates where
Loudest at heart base
Radiates to carotids
AS pulses
Pulsus parvus et tardus (weak and delayed)
End results of AS
Syncope
Angina
Dyspnea
Causes of AS
Calcific aortic stenosis Bicuspid aortic valve Rheumatic valve disease Congenital unicuspid valve disease Syphilis
VSD characteristic sound
Holosystolic, harsh
VSD loudest where
Loudest at Tricuspid area
What enhances VSD murmur
Hand grip
MVP characteristic sound
Late systolic crescendo with midsystolic click
What is the most frequent valvular lesion
MVP
MVP loudest where
Over apex just before S2
Causes of MVP
Myxomatous degeneration
Rheumatic fever
Chordae rupture
AR/PR characteristic sound
High-pitched blowing early diastoic decrescendo
What happens with chronic AR
Wide pulse pressure
How does AR present
Bounding pulses
Head bobbing
What causes AR
Aortic root dilation Bicuspid aortic valve Endocarditis Rheumatic fever Syphilis Marfan
What increases AR
Hand grip
What decreases AR
Vasodilators
MS/TS characteristic sound
Opening snap
Delayed rumbling late diastolic murmur
How do you know MS is severe
Decreased interval between S2 and opening snap
What causes MS
Secondary to Rheumatic fever
What enhances MS
↑ LA return (Expiration)
PDA characteristic sound
Continuous machine-like murmur
When is PDA loudest
S2
Where is PDA best heard
Left infraclavicular area
