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Year 3 Med 1 > Murmurs > Flashcards

Murmurs Flashcards

1
Q

What are the normal heart sounds

A

S1 and S2

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2
Q

What does the S1 represent

A

Closure of the mitral and tricuspid valves
start of ventricular systole
peripheral pulse can be felt at this time

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3
Q

What does the second heart sound represent

A

Closure of the aortic pulmonary valves
Splitting-> difference between aortic and then pulmonary valve closing

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4
Q

Levine scale of cardiac murmurs

A

Intensity from 1-6
1) very faint, only heard by expert in optimum conditions
2) Heard by a non-expert in optimum conditions
3) Easily audible, no thrill
4) A loud murmur, with a thrill
5) Very loud, often heard over a wide area, with thrill
6) Extremely loud, heard without a stethoscope

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5
Q

What are the 5 areas to hear murmurs on the precordium

A
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6
Q

Which murmurs are best heard at the Aortic area (upper right sternal border)?

A

Systolic murmurs
-aortic stenosis
-flow murmurs (e.g,. physiological)

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7
Q

Which murmurs are best heard in the pulmonary area? (left pulmonic area)

A

systolic ejection murmurs
- pulmonary stenosis
-atrial septal defect
-flow murmur

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8
Q

Which murmurs can be heard loudest at ERBs point (upper left sternal border)

A

Diastolic murmur
- aortic regurg
-pulmonic regurg

Systolic murmur
-hypertrophic cardiomyopathy

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9
Q

Which murmurs can be heard loudest at the tricuspid area? (mid left sternal border)

A

Holosystolic murmur
- tricuspid regurg
-VSD

Diastolic murmur
- tricuspid stenosis

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10
Q

Which murmurs are heard loudest at the mitral area (apex- midclavicular 4/5 interclavicular space)

A

Holosystolic- mitral regurg
Systolic- mitral valve prolapse
Diastolic- mitral stenosis

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11
Q

What are the systolic murmurs (8)

A

Ejection systolic
-aortic stenosis
-pulmonary stenosis

Pansystolic (holosystolic)
-mitral regurg
-tricuspid regurg
-VSD

Mid-systolic
-mitral valve prolapse
-ASD

Late systolic
-coarctation of aorta

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12
Q

Diastolic murmurs (4)

A

Early diastolic
-aortic regurg
-pulmonary regurg

Mid-late diastolic
-mitral stenosis
-tricuspid stenosis

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13
Q

What does RILE stand for?

A

Right sided murmurs louder on inspiration
Left sided murmurs louder on expiration

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14
Q

Aortic stenosis

A
  • ejection systolic murmur
  • heard loudest over aortic area when leaning forward
  • “crescendo-decrescendo”
  • radiates to carotid arteries
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15
Q

Pulmonary stenosis

A
  • associated with congenital heart defects like TOF
  • ejection systolic heard loudest over pulmonary area
  • loudest during inspiration
  • radiates to shoulders/ left infraclavicular
  • widely split
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16
Q

Mitral regurg

A
  • pansystolic murmur
  • high pitched and blowing in character
  • heard best at mitral area (apex (5th intercostal, right sternal border, midclavicular line)
  • radiates to axilla
17
Q

Tricuspid regurg

A
  • high pitched and blowing in character
  • heard best at tricuspid area
  • Tricuspid gets louder during inspiration, unlike mitral
18
Q

Ventricular septal defect

A

heard loudest at the left lower sternal border

19
Q

Mitral valve prolapse

A
  • mid-systolic heard with an opening click
  • loudest on expiration
  • apex
20
Q

Atrial septal defect

A
  • crescendo-decrescendo
  • machinery murmur
21
Q

Coarctation of aorta

A

congenital defect
heard loudest in the back below the left shoulder blade

22
Q

Aortic regurg

A
  • early diastolic
    decrescendo
  • water hammer pulse
  • heard loudest above the left sternal edge
  • high-pitched and blowing in character
    -associated with head bob
23
Q

Pulmonary regurg

A
  • Early decrescendo murmur heard loudest over the left sternal edge
  • Loudest during inspiration
  • Usually due to pulmonary hypertension
24
Q

Mitral stenosis

A
  • low pitched “rumbling”
  • opening click
  • loudest over apex
  • malar flush
  • associated with causing AF or Aflutter
25
Q

Tricuspid stenosis

A
  • soft diastolic murmur heard loudest over left sternal age 3rd-4th intercostal space
  • inspiration
  • raised JVP
  • peripheral oedema, ascites
26
Q

Patent ductus arteriosus

A

continuous murmur heard loudest under the left clavicle

Year 3 Med 1 (10 decks)

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