Heart murmurs Flashcards
Diastolic murmurs
Tricuspid stenosis
Mitral stenosis
Pulmonary regurgitation
Ao regurgitation
Systolic murmurs
Pulmonary stenosis Ao stenosis Tricuspid regurgitation Mitral regurgitation VSD
Opening snap after S2 that is enhanced with expiration
Mitral stenosis/Tricuspid stenosis
Causes of Mitral stenosis
Rheumatic fever (scarring of leaflets)
Complications of Mitral stenosis
Pulmonary HTA
Pulmonary congestion
Atrial fibrillation
Compression of left recurrent laryngeal nerve = hoarseness
High pitch blowing early diastolic decrescendo murmur after S2.
Ao. regurgitation
Characterized by hyperdynamic pulse, head bobbing, and wide pulse pressure
Ao. regurgitation
Causes of Ao. regurgitation
Ao. root dilation
Bicuspid Ao. valve
Endocarditis
Rheumatic fever
Complication of Ao. regurgitation
Left HF
Causes of Ao. root dilation
Syphilis
Marfan Syndrome
What is wide pulse pressure?
Normal systole/ high diastole
Continuos machine like murmur that runs through S1 to S2 but loudest at S2.
Patent ductus arteriosus
Causes of Patent ductus arteriosus
Congenital rubella
Prematurity
Best heard at the left infraclavicular region
Patent ductus arteriosus
Crescendo-decrescendo systolic ejection murmur with an ejection click, following S1
Ao. stenosis
Most common cause of Ao. stenosis in developed countries
Calcific degeneration of trileaflet Ao. valve
Most common cause of Ao. stenosis in developing countries
Rheumatic fever
Pathophisiology of Rheumatic fever
Fusion of valve comisures due to repetitive inflammation.
Pulsus parvus et tardus
Pulses are weak
In what murmur can you find Pulsus parvus et tardus
Ao. stenosis
Cause in younger patients of Ao. stenosis
Early onset calcification of bicuspid Ao. valve
Complications of Ao. stenosis
Syncope
Angina
Dyspnea on exertion
Loudest at heart base and radiates to carotids
Ao. stenosis
Holosystolic, high pitched “blowing murmur” following S1
Mitral/tricuspid regurgitation
Causes of Mitral regurgitation
Ischemic heart disease
LV dilation
Mitral valve prolapse
Rheumatic fever
Causes of tricuspid regurgitation
Right ventricular dilation
Rheumatic fever
Endocarditis (IV drug use)
Enhanced by increase in afterload (handgrip or squatting)
Tric/Mitral regurgitation
Murmur increases with inspiration
Tricuspid regurgitation
Murmur varies with respiration
Pulmonary regurgitation
Late systolic crescendo murmur with midsystolic click
Mitral valve prolapse = ballooning of mitral valve into left atrium during systole
Causes of Mitral valve prolapse
Myxomatous degeneration
Rheumatic fever
Chordae rupture
What is myxomatous degeneration and causes
1ary or 2ary connective tissue disease such as Marfan or Ehlers Syndrome
Most frequent valvular lesion
Mitral valve prolapse
Mitral valve prolapse can predispose to?
Infective endocarditis
Holosystolic, harsh-sounding murmur.
Loudest at tricuspid area that doesn’t radiate.
VSD
Crescendo-decrescendo systolic murmur best heard in the 2nd to 3rd IC space close to the sternum
Ao. stenosis
Early diastolic decrescendo murmur best heard along the left sternal border with BP of 160/55
Ao. regurgitation
Late diastolic decrescendo murmur heard best along the lower left sternal border
Tricuspid stenosis
Holosystolic murmur best heard at the apex and often radiates to the left axilla
Mitral regurgitation
Late systolic murmur usually preceded by a mid-systolic click
Mitral valve prolapse
Crescendo-decrescendo systolic murmur best heard at the 2nd-3rd left interspace close to the sternum
Pulmonary stenosis
Rumbling late diastolic murmur with an opening snap, loudest in the 5th interspace in the midclavicular line
Mitral stenosis
