Heart Murmurs

Question 1

“Machine gun murmur”

Answer 1

Patent ductus arterious (PDA)

Question 2

Ejection systolic murmur which radiates to the carotids is associated with what murmur?

Answer 2

Aortic stenosis

Question 3

Soft S2 murmur

Answer 3

Aortic stenosis

Question 4

Slow rising pulse, narrow pulse pressure

Answer 4

Aortic stenosis

Question 5

Main cause of aortic stenosis OVER 65

Answer 5

degenerative calcification

Question 6

Main cause of aortic stenosis UNDER 65

Answer 6

congenital bicuspid valve

Question 7

Causes of Aortic stenosis

Answer 7

degenerative calcification (>65),
congenital bicuspid valve (<65),
rheumatic disease,
hypertrophic cardiomyopathy

Question 8

Treatment of Aortic regurgitation

Answer 8

Valve replacement.

TAVI if unsuitable for surgery

Question 9

Early diastolic murmur

Answer 9

Aortic regurgitation

Question 10

Bounding/collapsing pulse

Answer 10

Aortic regurgitation

Question 11

Murmur heard L sternal angle, 4th intercostal space, with patient leaning forward.

Answer 11

Aortic stenosis

Question 12

Aortic stenosis manoeuvre is done using what side of the stethoscope?

Answer 12

Diaphragm (bigger side)

Question 13

What murmurs are associated with a displaced apex?

Answer 13

Aortic stenosis
Mitral regurgitation

(ejection systolic)

Question 14

Causes of Aortic regurgitation

Answer 14

rheumatic fever (females),
Infective endocarditis,
UC (rare),
Marfan's (rare),
SLE (rare)

Question 15

Treatment of Aortic stenosis

Answer 15

treat underlying condition

valve replacement

Question 16

Pathophysiology of Aortic stenosis

Answer 16

Reflux of blood from aorta through aortic valve into LV during diastole

Question 17

Malar flush

Answer 17

Mitral stenosis

Question 18

Tapping apex

Answer 18

Mitral stenosis

Question 19

Raised JVP

Answer 19

Mitral stenosis

Question 20

mid-late diastolic murmur

Answer 20

Mitral stenosis

Question 21

Murmur heard at apex when patient is lying on left side

Answer 21

Mitral stenosis

Question 22

Mitral stenosis manoeuvre is done with using what side of the stethoscope

Answer 22

Bell (smaller side)

Question 23

Loud S1 murmur with opening snap

Answer 23

Mitral stenosis

Question 24

Cause of Mitral stenosis

Answer 24

Rheumatic disease

Question 25

Treatment of Mitral stenosis

Answer 25

anticoagulants (risk of emboli)
Valve replacement
balloon valvotomy

Question 26

Murmur associated with AF

Answer 26

Mitral stenosis

Question 27

Pan-systolic murmur

Answer 27

Mitral Regurgitation

Question 28

Murmur radiates to axilla

Answer 28

Mitral Regurgitation

Question 29

Prominent 3rd heart sound

Answer 29

Mitral Regurgitation

Question 30

Causes of Mitral Regurgitation

Answer 30

rheumatic disease (most common)
calcification

Question 31

Treatment of Mitral Regurgitation

Answer 31

Valve replacement

Diuretic + ACEI if unsuitable for surgery