Murmurs

Question 1

A continuous, machine-like murmur is indicative of what pathology?

Answer 1

Patent ductus arteriosus

Question 2

A holosystolic high-pitched “blowing” murmur is indicative of what pathology?

Answer 2

mitral/tricuspid regurgitation

Question 3

A murmur due to aortic stenosis may radiate to the…

Answer 3

…carotid arteries

Question 4

A murmur due to mitral regurgitation may radiate to the…

Answer 4

…axilla.

Question 5

A murmur with a midsystolic click is indicative of what pathology?

Answer 5

mitral valve prolapse

Question 6

A murmur with an opening snap is indicative of what pathology?

Answer 6

mitral stenosis

due to abrupt halt in leaflet motion in diastole, after rapid opening due to fusion at leaflet tips

Question 7

Does a ventricular septal defect cause a systolic or diastolic murmur?

Answer 7

Holo-systolic

“harsh-sounding murmur”

Question 8

Does aortic regurgitation cause a systolic or diastolic murmur?

Answer 8

Diastolic

Question 9

Does aortic stenosis cause a systolic or diastolic murmur?

Answer 9

Systolic ejection murmur

Question 10

Does mitral stenosis cause a systolic or diastolic murmur?

Answer 10

Diastolic

Question 11

Does mitral valve prolapse cause a systolic or diastolic murmur?

Answer 11

Late systolic (with midsystolic click)

Question 12

Does mitral/tricuspid regurgitation cause a systolic or diastolic murmur?

Answer 12

Holo-systolic murmur

Question 13

How do regurgitation murmurs change with squatting and handgrip (e.g. AR, MR, VSD)?

Answer 13

Increase

Question 14

How do regurgitation murmurs change with standing and the Valsalva maneuver (e.g. AR, MR, VSD)?

Answer 14

Decrease

decreased preload

Question 15

How does the murmur of aortic stenosis change with handgrip?

Answer 15

Decrease

Question 16

How does the murmur of hypertrophic cardiomyopathy and mitral valve prolapse change with squatting?

Answer 16

Decrease

increased preload or afterload

Question 17

How does the murmur of hypertrophic cardiomyopathy and mitral valve prolapse change with standing?

Answer 17

Increase

these murmurs increase in intensity with decreased preload; all other murmurs decrease

Question 18

How does the murmur of hypertrophic cardiomyopathy and mitral valve prolapse change with the Valsalva maneuver?

Answer 18

Increase

these murmurs increase in intensity with decreased preload; all other murmurs decrease

Question 19

How does the murmur of hypertrophic cardiomyopathy change with handgrip?

Answer 19

Decrease

murmur decreases in intensity with increased preload or afterload

Question 20

What is the likely cause of this harsh-sounding murmur:

Answer 20

ventricular septal defect

Question 21

What is the likely cause of this high-pitched, “blowing” murmur:

Answer 21

mitral/tricuspid regurgitation

Question 22

What is the likely cause of this murmur:

Answer 22

aortic regurgitation

Question 23

What is the likely cause of this murmur:

Answer 23

aortic stenosis

Question 24

What is the likely cause of this murmur:

Answer 24

mitral stenosis

Question 25

What is the likely cause of this murmur:

Answer 25

mitral valve prolapse

Question 26

What is the likely cause of this murmur:

Answer 26

patent ductus arteriosus

Question 27

What is the shape of a murmur due to aortic regurgitation?

Answer 27

Early decrescendo

Question 28

What is the shape of a murmur due to aortic stenosis?

Answer 28

Crescendo-decrescendo an ejection click may be present

Question 29

What is the shape of a murmur due to mitral valve prolapse?

Answer 29

Late crescendo

Question 30

Where is a murmur due to aortic regurgitation the loudest?

Answer 30

Left sternal border diastolic murmur; note: pulmonic regurgitation may be heard in the same area

Question 31

Where is a murmur due to aortic stenosis the loudest?

Answer 31

Heart base (aortic area)

Question 32

Where is a murmur due to atrial septal defect the loudest?

Answer 32

Left upper sternal border diastolic mumur

Question 33

Where is a murmur due to hypertrophic cardiomyopathy the loudest?

Answer 33

Left sternal border typically heard as a crescendo-decrescendo murmur; may radiate to the apex

Question 34

Where is a murmur due to mitral regurgitation the loudest?

Answer 34

Apex (mitral area)

Question 35

Where is a murmur due to mitral valve prolapse the loudest?

Answer 35

Apex (mitral area)

Question 36

Where is a murmur due to ventricular septal defect the loudest?

Answer 36

Left lower sternal border holosystolic murmur