Heart Murmurs Flashcards
1
Q
Radiation
- AS
- AR
- MS
- MR
A
- carotid arteries
- L upper sternal border
- no radiation
- axilla
2
Q
stenosis vs. regurgitation
- harsh/rumble
- blowing
A
- stenosis, pressure overload
- regurgitation, volume overload
3
Q
what murmurs are accentuated by leaning forward
A
aortic murmurs
4
Q
what murmurs are accentuated by lying on left side
A
mitral murmurs
5
Q
What does increased venous return do to murmurs
- exception
A
- increases
- decreases hypertrophic cardiomyopathy and delayed ejection click
6
Q
What does decreased venous return do to murmurs
- exceptiond
A
- decreases
- increases hypertrophic cardiomyopathy and earlier ejection click
7
Q
what murmurs are increased by:
- inspiration
- expiration
A
- right side
- left side
8
Q
what do the following do:
- squatting
- handgrip
A
- increases venous return
- increases after load = reduced LV emptying
9
Q
AS
A
- systolic ejection click
- crescendo-decrescendo
- RUSB
- dec with valsalva, standing, handgrip
- inc with venous return (squatting), sit and lean forward
**rely on preload to maintain CO = avoid physical exertion/dilation and negative inotrops (CCB, BB)
10
Q
AR
- causes
A
- rheumatic fever
- endocarditis
- aortic root disease/dilation (HTN, marfan, etc.)
11
Q
AR
- murmur
A
- diastolic decrescendo
- blowing
- LUSB
- incr: squatting, sitting forward, handgrip, expiration
- dec: valsalva, standing
12
Q
AR
- tx
A
- after load reduction: vasodilators to improve forward flow (ACEi, ARB, Nifedipine)
13
Q
MS
- cause
A
- rheumatic heart disease **
14
Q
MS
- s/sx
A
- dyspnea, hemoptysis, pulmonary HTN
- a fib
- R sided HF
- ruddy flushed cheeks with facial pallor
15
Q
MS
- murmur
A
- opening snap
- early-mid diastolic rumble
- apex
- louder in LLD position
- incr with venous return (squatting)
- dec with reduced venous return (valsalva, standing)
