Heart sounds

Question 1

other than moderate mitral stenosis what can cause a loud P2 ?

Answer 1

pulmonary hypertension

Question 2

what causes S3

Answer 2

diastolic filling of the ventricle

heard in LVF / dilated cardiomyopathy

post MI

CONSTRICTIVE PERICARDITIS - PERICARDIAL KNOCK

Mitral regurgitation / aortic regurgitation

Question 3

what causes S4

Answer 3

extra sound causes by atrial contraction against a stiff ventricle

aortic stenosis
hypertension
It is associated with hypertrophic obstructive cardiomyopathy and hypertension

Question 4

Because S4 is caused during atrial contraction the S4 usually occurs with what in an ECG ?

Answer 4

P wave

Question 5

Ejection systolic murmur louder on expiration (LEFT SIDE)

Answer 5

aortic stenosis
hypertrophic obstructive cardiomyopathy

Question 6

Ejection systolic murmur louder on inspiration ? (right side)

Answer 6

pulmonary stenosis

atrial septal defect

also: tetralogy of Fallot
RV outflow tract obstruction (ALSO HAS VSD , OVERRIING AORTA , right ventricle hypertophy )

Question 7

Holosystolic (pansystolic)

Answer 7

mitral/tricuspid regurgitation (high-pitched and ‘blowing’ in character)

ventricular septal defect (‘harsh’ in character)

Question 8

how to differentiate between mitral and tricuspid regurgitation ?

Answer 8

tricuspid regurgitation becomes louder during inspiration, unlike mitral reguritation

Question 9

Late systolic murmur ?

Answer 9

mitral valve prolapse
coarctation of aorta

Question 10

Early diastolic murmur

Answer 10

aortic regurgitation
Graham-Steel murmur (pulmonary regurgitation, again high-pitched and ‘blowing’ in character)

Question 11

Mid-late diastolic murmur ?

Answer 11

mitral stenosis (‘rumbling’ in character)
Austin-Flint murmur (severe aortic regurgitation, again is ‘rumbling’ in character)

Question 12

Continuous machine-like murmur

Answer 12

patent ductus arteriosus

Question 13

fixed splitting of S2 ?

Answer 13

ASD