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Step 2 High Yield > Murmurs > Flashcards

Murmurs Flashcards

0
Q

Holosystolic murmur, left lower sternal border

Diastolic rumble

A

VSD

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1
Q

Harsh, systolic ejection murmur at left upper sternal border

Single S2

A

Pulmonic stenosis

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2
Q

High pitched 3/6 systolic murmur best heard at the second right intercostal space

A

Aortic stenosis

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3
Q

Loud first heart sound

Mid diastolic rumble

A

Mitral stenosis

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4
Q

Left lower sternal border

Decreases in intensity with an increase in preload

A

HOCM

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5
Q

Ejection systolic murmur at left lower sternal border that increases with valsalva

A

HOCM

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6
Q

Holosystolic murmur that radiates to the axilla

A

Mitral regurgitation

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7
Q

Holosystolic murmur that radiates to the right sternal border
Enhanced by inspiration

A

Tricuspid regurgitation

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8
Q

Crescendo-decrescendo systolic ejection murmur following an ejection click
Radiates to carotids/heart base

A

Aortic stenosis

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9
Q

Holosystolic harsh murmur
Loudest at tricuspid, left sternal border
Increases with increased afterload

A

VSD

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10
Q

Late systolic crescendo with mid systolic click

A

MVP

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11
Q 
Pulsus parvus et tarsus - pulses are weak with delayed peak
Syncope
Angina
Dypsnea 
Paradoxical splitting (p2 closer later)
A

Aortic stenosis

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12
Q

High-pitched blowing diastolic decrescendo murmur

A

Aortic regurgitation

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13
Q

Late rumbling diastolic murmur after opening snap

A

Mitral stenosis

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14
Q

Wide pulse pressure
Bounding pulses
Head bobbing
Pulsating nail bed

A

Aortic regurgitation

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15
Q

Continuous machine-like murmur

Best heard and left infraclavicular area

A

PDA

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16
Q

Chronic rheumatic fever

A

Mitral stenosis

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17
Q

Atrial fibrillation

A

Mitral stenosis due to LA dilation

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18
Q

CHF

A

Mitral regurgitation

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19
Q

Aortic dissection

A

Aortic regurgitation

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20
Q

Young black male

A

Auto-Dom HOCM

21
Q

Early diastolic murmur that starts with S2 and ends before S1
Decrescendo
Increases in intensity with inspiration
Heard best at left sternal border

A

Pulmonic regurgitation

22
Q

Pulmonary congestion
Pulmonary HTN
A-fib

A

Mitral stenosis

23
Q

Can hear your heartbeat when lying down at night

May have pounding in head

A

Aortic regurgitation

24
Q

Normal splitting

A

Inspiration: drop in intrathoracic pressure and increased venous return to right heart –> increased right heart stroke volume –> delayed closure of pulmonic

25
Q

Wide splitting

A

Seen in conditions that delay RV emptying (pulmonic stenosis, tricuspid regurgitation, ASD, TOF)

Pulmonic closes much longer after aortic

26
Q

Fixed splitting

A

Seen in ASD due to increase volumes in RA, left to right shunting and increased flow through the pulmonic

27
Q

Paradoxical splitting

A

Due to delayed emptying of LV (aortic stenosis, left bundle branch block, coarctation)

P closes later than A

28
Q

Pulsus paradoxus

A

Seen in patients with impaired cardiac filling. Increased RV volume pushes the intventricular septum over and causes a reduction in LV EDV and SV resulting in a decrease n BP during inspiration.

Defined as a decrease in systolic BP of over 10 mmHg during inspiration. Korotkoff sounds are heard first during expiration then throughout

29
Q

What conditions will you see pulsus paradoxus?

A 
Restrictive cardiomyopathy 
HOCM
Pericarditis
Tamponade 
Obstructive lung disease
30
Q

Best heard at apex with patient lateral recumbent

A

s4

31
Q

Due to an atrium contracting against a ventricle that has reached compliance

A

S4

32
Q

Early diastole sound due to rapid ventricular filling

A

S3

33
Q

Heard in late diastole

Right before S1

A

s4

34
Q

Early diastolic murmur best heard along the left sternal border between 3rd and 4th intercostal spaces

A

Aortic regurgitation due to valvular disease

35
Q

Early diastolic murmur best heard along the right sternal border

A

Aortic regurgitation due to aortic root dilatation

36
Q

Displaced apical impulse
Holosystolic murmur
Third heart sound

A

Mitral regurgitation

37
Q

What is the most common cause of mitral regurgitation in developed countries?

A

MVP due to myxomatous degeneration of the valve leaflets and chordae

38
Q

Exertional dypsnea
Dry cough
Holosystolic murmur
Fatigue

A

Mitral regurgitation

39
Q

Prolonged pr interval

Prolonged QRS

A

Bradyarrythmia

40
Q

Harsh systolic ejection murmur + single S2

A

TOF

41
Q

Short systolic murmur that disappears with squatting

A

MVP

42
Q

Systolic/diastolic murmur over right upper sternal border that is silenced when turning the head

A

Venous hum

43
Q

2/6 mid systolic murmur that radiates to the back and axilla in a child

A

Peripheral pulmonic stenosis

44
Q

2/6 early systolic murmur with vibratory character at left mid sternal border with normal splitting

A

Still’s murmur

45
Q

Soften S1

Pan systolic murmur loudest at apex

A

Mitral regurgitation

46
Q

Pansystolic murmur best heard at left sternal border with a thrill

A

Ventricular septal rupture

47
Q

Loud, palpable S2
A flow murmur
S4
Para sternal heave

A

Pulmonary HTN

48
Q

Jugular A wave

Loud P2

A

Pulmonary embolism

49
Q

Late systolic murmurs in a patient with UE HTN

A

Coarctation of the aorta with collateralz

50
Q

Hum or bruit at costovertebral angle

A

Renal artery stenosis from fibromuscular dysplasia

Step 2 High Yield (20 decks)

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