Heart Murmurs p 273 Flashcards
What are the systolic murmurs?
Mitral/Tricuspid Regurg
Aortic/Pulmonic Stenosis
VSD
Mitral Valve Prolapse
What is a holosystolic, high-pitched “blowing murmur”? Where is it heard best? What is it enhanced by? What causes these?
Mitral/Tricuspid Regurg - Rheumatic Fever/IE
Mitral - heard at apex w/ radiation toward axilla, enhanced by increased TPR (hand grip) (think about ischemic heart dz, MVP, LV dilation)
Tricuspid - heard at tricuspid area radiate to RSB, enhanced by increased venous return (inspiration) (think about RV dilation)
What is a crescendo/decrescendo murmur upon systolic ejection? Heard where? Symptoms? Causes?
Aortic Stenosis
Heard @ base, radiate to carotid. Pulsus parvus et tardus. Syncompe, angina, dyspnea (SAD), age realted calcific AS or bicuspid aorta
What is a holosystlic, harsh murmur? Heard where? Accentuated by what?
VSD, heard @ tricuspid area, accentuated w/ hand grip (increased after load)
What is a late systolic crescendo murmur w/ mid systolic click? Heard where? caused by?
MVP; click is due to tensing of chordae tendinae
Most frequent lesion; heard over apex
Predisposes to IE; caused by myxomatous degen, rheum fever, chordae rupture
What are the diastolic murmurs?
Aortic/Pulmonic regurg
Mitral/Tricuspid stenosis
What is a high-pitched blowing murmur in early diastole? Tell me some shit about it.
Aortic Regurg; wide pulse pressure when chronic (head bobbing!)
Aortic root dilation, bicuspid valve, endocarditis, rheum fever. Increased by hand grip (vasodilators decrease intensity)
What is a diastolic murmur that has an opening snap? Tell me about it
Mitral stenosis after OS (abrupt halt in leaflet motion in diastole after rapid opening due to fusion at leaflet tips) secondary to rheum fever, chronic MS results in LA dilation, enhanced by increased LA return (expiration)
What is a continuous machine like murmur?
PDA, loudest @ S2, congenital rubella or prematurity, best heard at left infraclavicular area
Keep PDA open with PGs
Close it with Indomethacin
