Heart Murmurs Flashcards
Draw Murmur:
Aortic Stenosis
Crescendo-Decresndo Systolic Ejection Murmur Paradoxical Splitting (delayed aortic valve closure) LVH, Weak Pulses, Syncope, Angina, Dyspnea
Most with coarctation have bicuspid valve
Most with bicuspid valve have no coarctation
Main Cause: abnormal structural development of valve leaflets (bicuspid valves will become stenotic early)
Draw Murmur:
Mitral Regurgitation
Holo-Systolic Murmur
“Blowing” (regurgitation)
Radiates to Axilla (b/c enlarged LV)
Intensifies with clenched fist (increased SVR)
S3 Sound, increased volume return to LV
Draw Murmur:
Mitral Valve Prolapse (MVP)
Mid-Systolic Click
Followed by crescendo murmur
Heard best at apex
Associated with Marfan Syndrome
Most often asymptomatic
Draw Murmur:
Aortic Stenosis
Systolic Crescendo-Decrescndo
S4, due to decreased compliance of LV (hypertrophy)
Weak S2, bc valves open very little
intensity of murmur nothing to do with amount of stenosis
Cause:
Adults - Wear and Tear, Calcification
Young - Congenital malformation (bicuspid)
Draw Murmur:
Aortic Regurgitation
High Pitched Diastolic
Decrescndo, with Austin Flint
Austin Flint = mid diastolic rumbling
“Blowing” (regurgitation)
Widened Pulse Pressure!!
(KEY FOR AORTIC REGURGITATION)
Sound Heard:
Atrial Septal Defect
Fixed Split S2
Increased blood flow to right heart delays closure of plum artery
Draw Murmur:
Ventricular Septal Defect
“Harsh” Holosystolic Mumur
High Pitch
Loudest at tricuspid
Left sided enlargement
Associated with fetal alcohol syndrome
Draw Murmur:
Patent Ductus Arteriosus (PDA)
Continuous Machine Like Murmur
Associated with Rubella, Prematurity, High Altitude
Blood travels from aorta BACK into RV
RVH and/or LVH, HF
Low extremity cyanosis
Tx: Indomethacin, reduces PGE, closes patency
Jugular Venous Pressure Wave, Sounds:
Pulmonic Stenosis
Prominent A wave (increased atrial contraction)
Pulmonic Valve click (stenotic leaflets reach their max)
Murmur similar to Aortic Stenosis
Visual Findings for Coarctation of Aorta
Tx
1) LVH
2) “Notching” on Ribs due to enlargement/growth of collaterals
Tx: PGE infusion, keep ductus arterioles patent (maintains perfusion to lower extremities), if preductal coarctation
ID Cause and Abnormalities of:
Tetralogy of Fallot
CXR, EKG Findings
Cause: interventricular septum moves anteriorly/superiorly
Abnormalities:
1) Pulmonic Stenosis
2) RVH
3) Overiding Aorta
4) VSD (R –> L shunt), degree depends on Pulm Stenosis
CYANOSIS!!
Children Learn to Squat (increase SVR)
CXR: Boot Shape (bc of RVH)
EKG: RAD
Treatment for Transposition of Great Arteries
PGE infusion, maintain PDA Arterial switch (with coronary arteries)
Cyanosis!
Associated with maternal diabetes
