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IC3 Blue Book > Heart Murmurs > Flashcards

Heart Murmurs Flashcards

1
Q

PC AS

A

SAD

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2
Q

Features AS

A 
Ejection systolic
1-6
Aortic
- 
Crescendo-decrescendo
Carotids
Systemic
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3
Q

Systemic AS

A 
4th HS
quiet S2 
Heaving apex
Ejection click 
Slow rising pulse
Narrow pulse pressure
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4
Q

ECG AS

A

LVH / LV strain pattern

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5
Q

CXR AS

A

NA

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6
Q

DDX AS

A

Aortic sclerosis
HOCM
PS
MR

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7
Q

Surgical treatment AS

A

Symptomatic- prognosis 3 years
A symptomatic with gradient > 50mmHg
Valvuloplasty if unfit for surgery

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8
Q

Causes of AR

A

RHD
IE
SYPHILIS

Bicuspid
HTN
AD

Marfans
RA
Ank spon

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9
Q

PC AR

A

SOB
Fatigue
Palpitations

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10
Q

Features of AR

A 
Early diastolic 
1-4
LLSE
sitting up and exp
Breath like high pitch blowing
- 
Systemic
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11
Q

Systemic features of AR

A

4

S3
Thrusting, displaced
Collapsing pulse 
Wide pulse pressure 
5 signs
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12
Q

5 signs of AR

A 
Corrigans
Quinke
DeMusset
Duroziez
Troubes
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13
Q

Corrigans

A

Exaggerated carotid

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14
Q

Quinke

A

Pulsating nail bed

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15
Q

DeMusset

A

Heading nodding

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16
Q

Duroziez

A

Diastolic femoral murmur

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17
Q

Troubes

A

Pistol shot femorals

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18
Q

CXR AR

A

Cardiomegaly

Heart failure

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19
Q

DDX AR

A

PR

Graham Steele

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20
Q

Treatment AR

A

Diuretics

Vasodilators

21
Q

Surgery AR

A

More than mild disease

DONT WAIT UNTIL IRREVERSIBLE

22
Q

MS Causes

A

Rheumatic heart disease

23
Q

PC MS

A 
SOB
Fatigue
Pulmonary oedema
Haemoptysis 
RHF
24
Q

Features of MS

A 
Mid- diastolic 
1-4 
Apex
On LHS exp 
Rumbling low pitched 
- 
Systemic
25
Q

Systemic features of MS

A

6

Opening snap 
Tapping apex
A fib 
LOUD S1 
Mitral facies 
Signs RHF
26
Q

ECG MS

A 
A fib (irregular r r, narrow QRS, no P waves) 
P mitrale= bifid P waves
27
Q

CXR MS

A

Large LA

Pulmonary venous congestion

28
Q

DDX MS

A 
Austin flint (severe AR)
Carey Coombs (rheumatic fever)
TS (usually rheumatic)
29
Q

Treatment of MS

A

A fib treatment and anti coagulation

Diuretics

30
Q

Surgery MS

A 
Valvuloplasty- more than mild
Valve replacement/ repair
- associated MR
- rigid, calcified
- persistent LA thrombus
31
Q

Causes of MR

A

7

RHD
IE

MVP
Post MI pap rupture

LV dilation
Marfans
SLE

32
Q

PC MR

A

SOB
FATIGUE
other LVF

33
Q

Features of MR

A 
Pan systolic 
1-6 
Apex
- 
Blowing 
Axilla 
Systemic
34
Q

Systemic features of MR

A

S3 gallop- quiet S1, obliterated S2
Thrusting, displaced
A fib
Audible click in valve prolapse

35
Q

ECG MR

A

A fib

VEBS

36
Q

CXR MR

A

Cardiomegaly (late)

Cardiac failure

37
Q

Differential MR

A

VSF (esp post mi)
TR
AS

38
Q

Treatment MR

A

A fib and anticoagulant
Diuretics
ACE inhibitors – since HTN worsens MR

39
Q

Surgery MR

A

More than mild
LV dysfunction
DONT WAIT IRREVERSIBLE

40
Q

Grade 1 murmur

A

Very faint, just audible, EXPERT optimal

41
Q

Grade 2 murmur

A

Quiet, just audible- non expert optimal

42
Q

Grade 3 murmur

A

Moderately loud

43
Q

Grade 4 murmur

A

LOUD + palpable thrill

44
Q

Grade 5 murmur

A

VERY LOUD + thrill + hear off chest with stethoscope

45
Q

Grade 6 murmur

A

VERY LOUD + thrill + hear without stethoscope

46
Q

Aortic sclerosis

A 
A symptomatic
Doesn't radiate to carotids
No slow rising pulse
Normal pulse pressure
S2= normal, loud
47
Q

Indications prosthetic valve

A

Elderly

Can’t use warfarin– pregnant/ case by case

48
Q

6 complications of prosthetic valves

A 
Structural valve failure
Para valvular leak
Thrombus/ obstruction
IE
intra vascular haemolysis 
(Warfarin related)
49
Q

Causes of AS

A

RHD
Ca bicuspid- 50-60
Ca tricuspid- 70+

IC3 Blue Book (16 decks)

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