Lecture 1: Heart Sounds Flashcards
Where is the listening post for the mitral valve?
Left 5th ICS at MCL
Where is the listening post for the tricuspid valve?
Left 4th ICS at SB
Which grades of murmur are associated with a palpable thrill?
Grade 4-6
Which grade of murmur is moderately loud?
Grade 3
Which grade of murmur is loud with palpable thrill?
Grade 4
What does the S1 and S2 sound signify?
- S1 = closure of the TV and MV
- S2 = closure of the AV and PV
Which sound is dull, low pitch; and best heard with the bell?
S2
Which heart sound is a ventricular gallop and which is an atrial gallop?
- S3 = ventricular gallop
- S4 = atrial gallop
What is the cause of the S4 heart sound?
Forceful ATRIAL contraction against STIFFENED low compliant ventricle
What are the systolic murmurs?
MI AS TI PS
What are 4 causes of continous murmurs?
- PDA (machinery)
- AV fistula
- ASD with high LA pressure
- Coarctation
Most common causes of chronic mitral regurgitation?
- MVP = most common
- MAC (mitral annular calcification)
Which cause of systolic murmur is characterized as blowing, prominent at apex; radiates into left axilla?
MR
Rumbling, diastolic murmur - low pitched; best heard at apex w/ the bell
Mitral Stenosis
What are the hallmark signs/sx’s of aortic stenosis?
- Exertional dyspnea
- Angina
- Syncope
- HF
Obstruction caused by aortic stenosis leads to what type of overload?
Pressure overload –> LVH
Which systolic murmur is harsh at 2nd ICS RSB; radiates into suprasternal notch/carotids?
Aortic Stenosis
Which valvular pathology is associated with narrow pulse pressure; decreased SV and systolic pressure + delayed pulse (parvis/tardus)?
Aortic Stenosis
3 major causes of chronic AR?
- Syphilis
- Marfan syndrome
- Ankylosing spondylitis
Which valvular pathology is associated with wide pulse pressure?
Aortic Regurgitation
3 major causes of acute AR?
- Infective endocarditis
- Aortic dissection
- BAV
What is the cause of a diastolic, decrescendo murmur, 3rd ICS LSB?
Aortic Regurgitation
Which valvular pathology is a blowing systolic murmur at the 4th ICS LSB; increases with inspiration (Carvallo’s sign)?
Tricuspid Regurgitation
Which valvular pathology is associated with a prominent “V” wave in JVP?
Tricuspid Regurgitation
Which valvular pathology is a diastolic murmur at the 4th ICS LSP; increases with inspiration (Carvallo’s sign) and decreases with expiration and valsalva?
Tricuspid Stenosis
Which valvular pathology has a diastolic, blowing murmur at 2nd ICS LSB?
Pulmonic Regurgitation
Which valvular pathology is associated with a Graha Steell murmur?
Tricuspid Regurgitation
Which valvular pathology has a systolic murmur w/ ejection click at 2nd-3rd ICS, LSB and radiates toward the left shoulder and increases on inspiration?
Pulmonary Stenosis
