Heart Murmurs

Question 1

Aortic Stenosis

Answer 1

crescendo-decrescendo systolic ejection murmur;

often d/t age-related calcification or early-onset calcification of bicuspid aortic valve

Question 2

Mitral/Tricuspid Regurgitation

Answer 2

holosystolic, high-pitched “blowing murmur”;
MR: most commonly d/t MVP, also d/t ischemic heart disease (post-MI), LV dilatation;
TR: often d/t RV dilitation

Question 3

Mitral valve prolapse

Answer 3

late systolic crescendo murmur w/ midsystolic click;
MOST FREQUENT valvular lesion;
can predispose to infective endocarditis, can be caused by myxomatous degeneration (primary or secondary to Marfan or Ehlers-Danlos), rheumatic fever, chordae rupture

Question 4

VSD

Answer 4

holosystolic, harsh-sounding murmur;

loudest at tricuspid area

Question 5

Aortic Regurgiation

Answer 5

high-pitched “blowing” early diastolic decrescendo murmur;
often d/t: aortic root dilation, bicuspid aortic valve, endocarditis, rheumatic fever;
progresses to LHF

Question 6

Mitral Stenosis

Answer 6

follows opening snap;
delayed rumbling late diastolic murmur (decreased interval between S2 and OS correlates with increased severity);
most common cause is rheumatic fever from recurrent attacks of RF over many years

Question 7

PDA

Answer 7

continuous (systolic and diastolic) machine-like murmur, loudest at S2;
often d/t congenital rubella or prematurity, best heard at left infraclavicular area