Murmurs Flashcards
What are murmurs?
Heart sounds caused by turbulent blood flow
Which 2 murmurs can you extenuate using dynamic manoeuvres?
- Aortic regurgitation
2. Mitral Stenosis
How can you emphasise a mitral stenosis murmur?
Lie the patient on their left, listen to the apex/mitral area with the BELL whilst they hold their breath on deep expiration.
How can you emphasise an aortic regurgitation murmur?
Sit the patient forward and listen to the lower LSB (tricuspid area) with the DIAPHRAGM whilst they hold their breath on deep expiration.
Murmur that causes collapsing pulse?
Aortic Regurgitation
Murmur that causes pulsating nail beds (Quincke’s sign)
Aortic Regurgitation
Murmur that causes a visibly pulsating carotid? (Corrigan’s sign)
Aortic Regurgitation
Murmur that causes a head bopping pulse (De Musset’s sign)?
Aortic Regurgitation
Murmurs that can cause a displaced apex beat?
Aortic and Mitral Regurgitation
Murmur that causes a wide pulse pressure?
Aortic Regurgitation
What are narrow and wide pulse pressures? Which murmurs cause them?
The difference between diastolic and systolic are wide or narrow.
- narrow = aortic stenosis
- wide = aortic regurgitation
Murmur that causes a slow rising pulse?
Aortic Stenosis
Murmur that causes a heaving apex beat?
Aortic Stenosis
What are the 3 classical symptoms of Aortic Stenosis?
“SAD”
Syncope (exertional)
Angina pain
Dyspnoea (exertional)
Early diastolic murmur
Aortic Regurgitation
Ejection systolic murmur (2)
- Aortic Stenosis
2. Pulmonary Stenosis
Pan systolic murmur (2)
- Mitral Regurgitation
2. Tricuspid Regurgitation
Murmur that causes a narrow pulse pressure?
Aortic Stenosis
Murmur that causes a parasternal heave?
Tricuspid Regurgitation
Commonest cause of Aortic Stenosis?
Age-related calcification
Mid-diastolic murmur
Mitral Stenosis
Murmur that causes Malar flush?
Mitral StenoSiS
The 2 murmurs that can present with AF?
- Mitral Regurgitation
2. Mitral Stenosis
Murmur that causes a tapping apex beat
Mitral Stenosis
Murmur that can present with signs of hepatic pain, oedema, ascites?
Tricuspid Regurgitation
Murmur that can present with signs of LVHF (S3 gallop, pulmonary oedema)
Mitral Regurgitation
Murmur that can radiate to the carotids
Aortic Stenosis
Murmur that can radiate to the axilla?
Mitral Regurgitation
Condition that produces a continuous machinery murmur
Patent Ductus Arteriosus
Murmur that radiates to the back?
Pulmonary Stenosis
Name of the tool used to grade the intensity of a murmur?
Levine
Patients with murmurs will classically present with what type of symptoms? (3)
Dyspnoea, fatigue, palpitation
