Heart Murmurs

Question 1

What is Mitral Regurgitation?

Answer 1

Backflow of blood through mitral valve during systole

Question 2

Causes of Mitral Regurgitation?

Answer 2

LV dilation, Rheumatic fever, infective endocarditis, mitral valve prolapse, post-MI

Question 3

Symptoms of Mitral Regurgitation?

Answer 3

Dyspnoea, fatigue, palpitations

Question 4

Features of Mitral Regurgitation?

Answer 4

Pansystolic murmur radiating to axilla

Question 5

Tests for Mitral Regurgitation?

Answer 5

ECG (AF), CXR, Echo (LV function)

Question 6

Management for Mitral Regurgitation?

Answer 6

AF treatment, diuretics for symptoms, valve replacement if deterioration

Question 7

What is Mitral Stenosis?

Answer 7

Narrowing of mitral valve orifice

Question 8

Causes of Mitral Stenosis?

Answer 8

RF, congenital

Question 9

Symptoms of Mitral Stenosis?

Answer 9

pulm HTN - dyspnoea, haempotysis (<2cm)

Question 10

Features of Mitral Stenosis?

Answer 10

Mid-diastolic murmur

Question 11

Extra features of Mitral Stenosis?

Answer 11

Malar flush, low volume pulse, AF, RV heave

Question 12

Management for Mitral Stenosis?

Answer 12

AF treatment, diuretics, valve replacement

Question 13

What is Aortic Stenosis?

Answer 13

Narrowing of aortic valve orifice

Question 14

Causes of Aortic Stenosis?

Answer 14

Senile calcification

Question 15

Presentation of Aortic Stenosis? (triad)

Answer 15

angina, syncope, heart failure

Question 16

Features of Aortic Stenosis?

Answer 16

Ejection systolic murmur radiating to the carotids

Question 17

Extra features of Aortic Stenosis?

Answer 17

Slow rising pulse, displaced apex beat, LV heave

Question 18

Management of Aortic Stenosis?

Answer 18

Valve replacement

Question 19

What is Aortic Regurgitation?

Answer 19

Backflow of blood through aortic valve

Question 20

Causes of Aortic Regurgitation?

Answer 20

Acute - infective endocarditis, aortic dissection, chest trauma
Chronic - congenital, CTDs, RF, Takayasu’s arteritis, RA, SLE

Question 21

Symptoms of Aortic Regurgitation?

Answer 21

Exertional dyspnoea, orthopnoea, paroxysmal nocturnal dyspnoea (PND)

Question 22

Features of Aortic Regurgitation?

Answer 22

Early diastolic murmur

Question 23

Extra features of Aortic Regurgitation?

Answer 23

Collapsing pulse, wide pulse pressure, displaced apex beat

Question 24

Management of Aortic Regurgitation?

Answer 24

Antihypertensives (ACE-i), Echo every 6-12m to monitor, valve replacement if severe

Question 25

Mitral Stenosis is best heard?

Answer 25

Patient lying to his/her left side, breath held in expiration, over apex

Question 26

Aortic regurgitation is best heard?

Answer 26

Patient leaning forward in expiration, over LSE