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Summative > Murmurs > Flashcards

Murmurs Flashcards

1
Q

S1

A

closure of AV valves

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2
Q

AV valves

A

mitral and tricuspid

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3
Q

S2

A

closure of SL valves

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4
Q

SL valves

A

aortic and pulmonic

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5
Q

systolic ejection, crescendo-decrescendo mumur
radiates to carotid artery w/ narrow pulse pressure that is mid-systolic

A

aortic stenosis

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6
Q

blowing decrescendo rumbling murmur, high pitch no radiation

A

aortic regurg

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7
Q

rumbling decrescendo mid-diastolic w/ opening snap mumumur and no radiation

A

mitral stenosis

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8
Q

holocystolic blowing murmur radiates to left axilla

A

mitral regurg

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9
Q

crescendo- decresendo murmur heard at the left upper sternal border; systolic ejection murmur

A

pulmonic stenosis

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10
Q

high pitched decresendo mumur

A

pulm regurg

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11
Q

soft opening, scratching rumble w/ increased JVD murmur?

A

tricuspid stenosis

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12
Q

holocystolic murmur high pitched blowing

A

tricuspid regurg

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13
Q

What are the midsystolic murmurs?

A
  1. aortic stenosis
  2. pulmonic stenosis
  3. atrial septal defect
  4. HOCM
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14
Q

What are the holosystolic murmurs?

A
  1. mitral regurgitation
  2. tricuspid regurgitation
  3. VSD
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15
Q

What is the late systolic murmur?

A

mitral valve prolapse (lapse = late)

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16
Q

what are the early diastolic murmurs?

A
  1. aortic regurgitation
  2. pulmonic regurgitation
  3. austin-flint
17
Q

what is the mid/late diastolic murmur?

A
  1. mitral stenosis
  2. tricuspid stenosis
18
Q

rumbling-diastolic (mid-late) best heard at the apex, severe aortic regurg

A

austin- flint murmur

19
Q

what murmurs increase and decrease with inspiration?

A

right increase
left decrease

20
Q

what murmurs increase and decrease with squatting?

A

increase MS, AS, aortic insufficency
decrease Hypertrophic cardiomyopathy

21
Q

what increases and decreases with standing?

A

increases hypertrophic cardiomyopathy
decreases aortic stenosis, MR

22
Q

what increases and decreases with valsalva?

A

increases hypertrophic cardiomyopathy, MVP
decreases almost all

23
Q

What is HFrEf?

A

LV systolic dysfunction with S3 gallop
impaired contractility
increased diastolic
EF< 40 %

24
Q

What is HFpEF?

A

LV filling and relaxation impaired
EF> 40%
S4 gallop

25
Q

What are all the NYHA classes?

A

Class 1: no limitations of physical activity
Class 2: slight limitations, sxs w/ moderate exertion
class 3: mod. limitations, sxs w/ mild exertion
class 4: unable to carry out any physical activity w/o discomfort

26
Q

Right sided HF s/s

A

systemic
ascites, hepatomegally, decreased bowel perfusion
JVD

27
Q

S/S of left sided heart failure

A

think pulmonary
crackles at the lung base
dullness to percusion
JVD, displaced PMI
peripheral edema
orthopnea
chronic cough

28
Q

What is the treament guideline for heart failure?

A

ARNI (entresto)
ACEI (pril)/ arbs (sartan)
BB
SGT2-I ( jardiance/ forxiga)
MRA (spironolactone)
loop diuretics

29
Q

What are the two IV medications for heart failure?

A

Iv dobutamine and Iv milrnone

30
Q

Explain all of dilated cardiomyopathy? causes? S/S? PE? DX? TX?

A

Causes: “ Im mad my pump failed”
Idiopathic, myocarditid, alcohol, drugs, medications, pregnancy, family inherited
S/S: extertional intolerance
PE: pulmonary rales, S3 Gallop, periheral edema, ascites
TX: underlying causes + HErEF treatment

31
Q

Explain all of Hypertrophic cardiomyopathy? causes? S/S? PE? DX? TX?

A

Causes: genetic, diastolic dysfunction
asymmetrical growth - left ventricle larger
s/s: syncope (SOB w/ activity, exertional fatigue)
PE: murmur decreased w/ squatting or hadgrips
murmur increased w/ valsalba + rapid movement
EKG: LVH
echo (gold standard): EF < 60 %
TX: BB

32
Q

Explain all of Restrictive cardiomyopathy? causes? S/S? PE? DX? TX?

A

systolic and diastolic dysfunction
Causes: amyloidosis (mc)
S/S: SOB, fatigue, peripheral edema, hepatomegally
Dx: echo -> small ventricles that are thick or rigid w/ pulmanary HTN
EF: -> 20- 50 %
Tx: Diuretics + bp

33
Q

Explain all of stress cardiomyopathy? causes? S/S? PE? DX? TX?

A

Tako-tsubo syndrome ( broken heart syndrome)
EKG: ST-elevation w/ deep anterior T wave inversion, LV wall thickening
Tx: similar to MI -> ASA, BB, ACEI

34
Q

Aortic Stenosis Triad?

A
  1. Chest pain
  2. Dyspnea
  3. Syncope

Summative (14 decks)

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