Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pattern Recognition > Heart Sounds > Flashcards

Heart Sounds Flashcards

1
Q

What are the normal heart sounds and what do they represent?

A

S1 - mitral & tricuspid valve closure, marks beginning of ventricular systole
S2 - aortic & pulmonary valve closure, marks beginning of diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When is S1 LOUD?

A
  • Mitral stenosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When is S1 SOFT?

A
  • Mitral regurgitation

- Low cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When is the S1 intensity VARIABLE?

A
  • AF
  • Ectopic beats
  • Complete heart block
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is S2 composed of?

A

A2 - closure of the aortic valve

P2 - closure of the pulmonary valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is ‘physiological splitting’?

A

A2 & P2 can both be heard, with P2 delayed (approx. 50ms after A2)
- Occurs on inspiration - increase in venous return to the right heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When is physiological splitting WIDENED?

A 
Delayed/prolonged RV emptying
- RBBB
- Pulmonary stenosis
A2 occurs earlier (shortened LV emptying)
- Ventricular septal defect
- Mitral regurgitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is REVERSED SPLITTING and when is it heard?

A 
A2 occurs after P2
Heard in prolonged LV emptying:
- LBBB
- Aortic stenosis
Best heard in EXPIRATION
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is FIXED SPLITTING and when is it heard?

A

No variation with respiration

Characteristic of atrial septal defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When is A2 LOUDER?

A

Systemic HTN

- Forceful aortic valve closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When is A2 SOFTER?

A

Calcified aortic stenosis

Aortic regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When is P2 LOUDER?

A

Pulmonary HTN

- Forceful pulmonary valve closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is S3?

A

ABNORMAL - additional heart sound heart after S2 (‘gallop rhythm’)

  • Low-pitched
  • Early diastole
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does S3 represent?

A

Rapid ventricular filling

  • Can be normal in young people, athletes, pregnancy
  • Older patients = reduced LV compliance:
    • Heart failure
    • Aortic or mitral regurgitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is S4?

A

ABNORMAL - additional heart sound heart just prior to S1

  • Low-pitched
  • Late diastole
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does S4 represent?

A

Atrial contraction against a poorly compliant LV - ALWAYS PATHOLOGICAL

  • LVH
  • IHD
  • HTN
  • Aortic stenosis
17
Q

What are 4 additional heart sounds?

A

Opening snap
Ejection click
Mid-systolic click
Pericardial rub

18
Q

What is an ‘opening snap’ and what causes it?

A

High-pitched sound just after S2
- Mitral stenosis –> sudden opening of valve
- Followed by mid-diastolic murmur
Best heard at APEX or LEFT STERNAL EDGE

19
Q

What is an ‘ejection click’ and what causes it?

A

High-pitched sound just after S1
- Aortic or pulmonary stenosis –> sudden opening of valve
- Followed by an ejection systolic murmur
Best heard at AORTIC/PULMONARY areas or LEFT STERNAL EDGE

20
Q

What is a ‘mid-systolic click’ and what causes it?

A

High-pitched sound in mid-systole
- Mitral valve prolapse
- Usually followed by late systolic murmur
Best heard at APEX

21
Q

What is a ‘pericardial rub’ and what causes it?

A

Scratchy sound in both systole & diastole
- Pericarditis
- Can come & go rapidly
Best heard with patient SITTING UPRIGHT at END-EXPIRATION

22
Q

Name the 3 types of systolic murmur

A

Ejection systolic
Pansystolic
Late systolic

23
Q

Describe an ejection systolic murmur and list the causes

A

Crescendo-decrescendo, usually preceded by Ejection Click

  • Aortic stenosis (aortic area, radiates to carotids)/pulmonary stenosis (pulmonary area)
  • Hypertrophic obstructive cardiomyopathy (LSE)
  • Increased flow (‘flow murmurs’ - aortic area)
    • Pregnancy
    • Anaemia
    • Fever
    • L-to-R shunt (atrial septal defect)
24
Q

Describe a pansystolic murmur and list the causes

A

Continuous throughout systole (S1-S2)

  • Mitral regurgitation (apex, radiates to axilla)
  • Tricuspid regurgitation (lower LSE)
  • Ventricular septal defect (lower LSE)
25
Q

Describe a late systolic murmur and list the causes

A

Begins after S1, usually preceded by mid-systolic click, continues to S2

  • Mitral regurgitation secondary to:
    • Mitral valve prolapse
    • Papillary muscle dysfunction
26
Q

Name the 2 types of diastolic murmur

A

Early diastolic

Mid-diastolic

27
Q

Describe an early diastolic murmur and list the causes

A

Peaks at start of S2, gradually diminishes

  • Aortic regurgitation (lower LSE, patient leaning forward, end-expiration)
  • Pulmonary regurgitation
28
Q

Describe a mid-diastolic murmur and list the causes

A

Low-pitched ‘rumbling’ murmur, loudest in the middle of diastole. Usually preceded by Opening Snap.

  • Mitral stenosis (apex, left lateral decubitus)
  • Tricuspid stenosis (rare)
29
Q

What would cause a continuous murmur?

A

Patent ductus arteriosus

Pattern Recognition (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions