Heart Murmurs Uworld Flashcards
Maneuver: inspiration
Change in cardiac parameters =
Murmurs that increase =
Murmurs that decrease =
Change in Cardiac parameters: increased venous return to right heart, decreased venous return to left heart
Murmurs that increase: most right side murmurs
Murmurs that decrease: most left side murmurs
Maneuver: Valsalva strain phase
Change in cardiac parameters: decreased preload
Murmurs that increase: MVP, HCM (decreased in LV volume)
Murmurs that decrease: most others (because flow through stenotic or regurgitant valves decreases)
Maneuver: abrupt standing
Change in cardiac parameters: decreased preload
Murmurs that increase: MVP, HCM (decrease in LV volume)
Murmurs that decrease: most others (because flow through stenotic or regurgitant valves decreases)
Maneuver: squatting
Change in cardiac parameters: increased preload and increased afterload
murmurs that increase: most other murmurs increase because of increased flow through stenotic or regurgitant valves
murmurs that decrease: MVP, HCM
Maneuver: passive leg raise
change in cardiac parameters: increased preload and afterload
increases murmurs: most, flow across stenotic or regurgitant valves increases
decreased murmurs: MVP, HCM
Maneuver: handgrip
increases afterload
increased murmurs: AR, MR, VSD (increased LV volume)
decreased murmurs: HCM (LV volume increased), AS (decreased transvalvular pressure gradient)
crescendo-decrescendo @ RUSB
aortic stenosis
holosystolic @ apex and radiates to axilla
mitral regurg
crescendo-decrescendo mid-left sternal border
hypertrophic cardiomyopathy
midsystolic click followed by late systolic murmur
mitral v. prolapse
midsystolic with wide and fixed splitting S2
atrial septal defect
holosystolic @ left sternal border
VSD
decrescendo @ LUSB or RUSB
aortic regurg
LUSB = valvular RUSB = aortic root
opening snap followed by mid diastolic rumble with presystolic accentuation
mitral stenosis
machine like interscapular region posteriorly
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