Heart Murmurs

Question 1

when would you hear aortic stenosis

Answer 1

early to mid systolic.

Question 2

Where is aortic stenosis heard best?

Answer 2

over the base

Question 3

Does aortic stenosis radiate?

Answer 3

yes, to the carotids

Question 4

symptoms of aortic stenosis

Answer 4

• angina
• syncope
• dyspnea on exertion

Question 5

what can cause aortic stenosis?

Answer 5

1. degenerative calcification
2. rheumatic disease
3. bicuspid valve

Question 6

Presents w/holocystolic murmur heard best at the apex =

Answer 6

mitral regurgitation

Question 7

Does mitral regurgitation murmur radiate?

Answer 7

to the axilla

Question 8

what could lead to mitral insufficiency

Answer 8

1. rheumatic heart disease
2. congenital
3. acute MI w/papillary muscle dysfunction
4. endocarditis
5. calcification w/age

Question 9

symptoms of mitral regurg

Answer 9

ACUTE = pulmonary edema & shortness of breath

CHRONIC = severe fatigue, atrial fibrillation

Question 10

Presents as diastolic murmur heard best at APEX

Answer 10

mitral stenosis

Question 11

characteristic of mitral stenosis murmur is..

Answer 11

low pitched rumble preceded by opening snap

Question 12

causes of mitral stenosis

Answer 12

1. rheumatic heart disease

2. rarely congenital

Question 13

symptoms of mitral stenosis

Answer 13

1. dyspnea w/exertion and cough
2. hemoptysis (blood and sputum)
3. arterial embolism

Question 14

diastolic murmur head best at base with patient sitting

Answer 14

aortic regurgiation

Question 15

Classic symptom of aortic regurg..

Answer 15

water hammer pulse due to the increased pulse pressure from increased stroke volume

Question 16

etiology of aortic regurg

Answer 16

1. 2/3 is rheumatic endocarditis
2. trauma
3. congenital

Question 17

symptoms of aortic regurg

Answer 17

1. uncomfortable awareness of ones own heart when lying down
2. exertional dyspnea followed by orthopnea and PND
3. angina
4. CHF

Question 18

Very common murmur that has mid or late systolic click heard best at the APEX

Answer 18

mitral valve prolapse

Question 19

cause of mitral valve prolapse

Answer 19

myxomatous degeneration of posterior leaflet

Question 20

Tx for mitral valve prolapse

Answer 20

reassure

Question 21

Diastolic murmur heard at left sternal border and xiphoid. Has giant a wave in neck.

Answer 21

Tricuspid stenosis

Question 22

holosystolic murmur heard at lower left sternal border - has prominent V WAVES in the neck

Answer 22

tricuspid regurgitation

Question 23

what is tricuspid regurgiation a sign of?

Answer 23

right sided heart failure

Question 24

midsystolic murmur at left 2nd and 3rd interspaces. Preceded by ejection click.

Answer 24

Pulmonic stenosis

Question 25

6 traits of innocent murmurs

Answer 25

1. systolic ejection in nature
2. occur w/o physiological abnormalities
3. grade I or II
4. no thrills or radiation
5. end before S2
6. found in 30-50% of kids