heart sounds

Question 1

What’s this sound?

Answer 1

aortic regug with tambour S2

Tambour S2: loud and ringing S2 due to the dilation of aortic root (e.g. due to Marfan’s syndrome, syphilitic aortitis)

Question 2

name that sound

Answer 2

mitral stenosis with opening snap

Question 3

name that sound

Answer 3

mitral regurg

o Auscultation:
• Blowing, holosystolic, heard at apex, radiates to axilla
• May have diastolic flow murmur (severe insufficiency)
• Soft S1
• Widely split S2 (due to early closure of aortic valve)
• S3 common

o Physical sx:
• Left sided heart failure: dyspnea on exertion, orthopnea, PND

o Physical signs:
• Bounding pulses but normal pulse pressure (vs AR)
• Inferolaterally displaced PMI (volume overload)
o Cause:
• Dilated cardiomyopathy
• Rheumatic heart disease
• Myxomatous valve degeneration (+mid systolic click)
• Papillary muscle/chordae tendineae rupture (MI, endocarditis)
o

Question 4

name that sound

Answer 4

S4 gallop

Question 5

name that sound

Answer 5

aortic stenosis

Question 6

name that sound

Answer 6

early systolic ejection sounds

Question 7

name that sound

Answer 7

PDA

Question 8

name that sound

Answer 8

mid systolic click

Question 9

name that sound

Answer 9

S3 gallop

Question 10

name that sound

Answer 10

pericardial friction rub

Question 11

name that sound

Answer 11

aortic regurg with systolic flow murmur

Question 12

name that sound

Answer 12

opening snap