MURMURS Flashcards
widely split S2 that varies with respiration
Venous congestion increases the capillary hydrostatic pressure, this is seen in
right sided heart failure
loud s1
In patients with mitral stenosis (MS) and mobile leaflets (i.e., in mild to moderate MS), a loud S1 is often present because the increased left atrial pressure moves the mitral leaflets further apart during diastole so that the leaflets snap shut with a greater velocity at the start of ventricular systole.
s1 is best heard where?
5th left intercostal space in the midclavicular line (cardiac apex)
opening snap followed by a low-pitched diastolic murmur with presystolic accentuation
mitral stenosis (MS)
mitral stenosis: right or left heart failrue
left
tricuspid stenosis: right or left heart
right
opening snap hear immediately after S2 (early diastole)
tricuspid stenosis
s1 is made by the sound of what?
mitral and tricuspid valve closure
aortic valve closure generates the A2 component of S_
aortic valve closure generates the A2 component of S2
Late diastolic contraction of the atria (“atrial kick”) against a stiff, noncompliant ventricle can cause …
an S4
can be seen in patients with diastolic dysfunction, hypertrophic cardiomyopathy
LATE DIASTOLIC
Rapid ventricular filling, which occurs during early diastole, can generate S_
Rapid ventricular filling, which occurs during early diastole, can generate S3
When can we hear an s3?
in high volume/output states w/ rapid ventricular filling, which occurs during early diastole, can generate S3 if the ventricular filling pressure is increased (e.g., mitral regurgitation, heart failure) or if the ventricles are dilated (e.g., dilated cardiomyopathy
What type of murmur is associated with Aortic Stenosis?
Harsh crescendo-decrescendo systolic murmur, best heard at the right upper sternal border, radiates to the carotids, increases with squatting, decreases with Valsalva.
What type of murmur is associated with Mitral Regurgitation?
Blowing holosystolic murmur, best heard at the apex, radiates to the axilla, increases with handgrip, decreases with Valsalva.
What type of murmur is associated with Tricuspid Regurgitation?
Blowing holosystolic murmur, best heard at the left lower sternal border, increases with inspiration (Carvallo’s sign).
What type of murmur is associated with Ventricular Septal Defect (VSD)?
Harsh holosystolic murmur, best heard at the left lower sternal border, increases with handgrip.
What type of murmur is associated with Mitral Valve Prolapse (MVP)?
Late systolic murmur with a midsystolic click, best heard at the apex, increases with Valsalva, decreases with squatting.
What type of murmur is associated with Aortic Regurgitation?
Blowing early diastolic murmur, best heard at the left sternal border, increases with handgrip, associated with a wide pulse pressure and bounding pulses.
What type of murmur is associated with Mitral Stenosis?
Opening snap followed by a rumbling mid-diastolic murmur, best heard at the apex in the left lateral decubitus position.
What type of murmur is associated with Patent Ductus Arteriosus (PDA)?
Continuous ‘machine-like’ murmur, best heard in the left infraclavicular area.
