Heart Sounds Flashcards
Which is usually softer: S1 or S2?
S1 is softer
Which is usually softer: right or left sided heart sounds?
Right sided
Where are S3 and S4 best heard? Which side of the stethoscope should be used?
At the apex, with the bell
How are systolic murmurs graded?
1-6
How are diastolic murmurs graded?
1-4
What is the naming convention for murmurs?
Grade cycle intensity radiation
What are the three causes of pulmonic stenosis?
- Congenital heart structural disease
- Rheumatic valvular disease
- Carcinoid syndrome
What are the two major causes of tricuspid regurgitation?
Infection
Rheumatic fever
What are the four major causes of pulmonic regurgitation?
- Rheumatic valvular disease
- Carcinoid syndrome
- Pulmonary HTN
- CT diseases
What are the three major causes of tricuspid stenosis?
- Rheumatic valvular disease
- Congenital heart structural disease
- Age/calcification
What are the three major causes of aortic stenosis?
- Age/calcification
- Congenital disease
- Infective endocarditis
Why is it that pts with Hypertrophic cardiomyopathy are better with higher volumes?
Increased filling of the ventricle makes the septal hypertrophy a more minor contributor to outflow obstruction
Where is the murmur from HCM heard best? Why?
Apex d/t backflow from
What are the four major causes of aortic regurgitation?
- Endocarditis
- Root dilation
- Congenital (bicuspid valve)
- CT disorder
Where does mitral stenosis radiate to?
Precordial area
Does increased volume return make the murmur with mitral stenosis worse or better?
worse
What are the two major causes of mitral stenosis?
Infective endocarditis
Calcific changes
What happens to the OS with mitral valve prolapse when there is decreased systolic volumes?
Moves OS earlier
What happens to the OS with mitral valve prolapse when there is increased systolic volumes?
Moves the OS later
What is the effect of aortic regurgitation on the murmurs from a VSD and mitral regurg?
Increases d/t increased LV filling/volume
What is the effect of aortic regurgitation on HCM murmur? Why?
Decreases, since it increases LV filling
What is the effect of standing with HCM?
Increases murmur d/t decreased LV filling
What is the effect of sitting/lying down with HCM?
Decreases murmur d/t increased LV filling
What is the effect of the valsalva maneuver on HCM?
Bearing down reduces return and LV volume, increasing stenosis
What is the effect of hand grip on mitral regurgitation?
Increases SVR and LV pressure, thereby increasing the pressure gradient between the LV and LA
What position of the patient is best for hearing S3 and S4?
Left lateral recumbent
What is the treatment for mitral regurg? Why?
- ACEIs
- Diuretics
Reduce the ssx of HF
What is the treatment for dilated cardiomyopathy?
- Diuretics
- ACEIs
- Beta blockers
What is the treatment for aortic stenosis?
Positive inotropes
What is the treatment for mitral regurg?
Decrease BP
Increase inotropy
What is the treatment for mitral stenosis?
Increase
