murmurs Flashcards
S 1
closure of mitral/tricuspid valves. loudest at the mitral area.
S 2
aortic/pulmonic closure. loudest at the left upper sternal border.
S 3
in early diastole during rapid filling increased filling pressure. indicative of mitral regurg or HF -common with dilated ventricles.
S4
late diastole atrial kick. best heard at the apex in the left lateral decubitus position. high atrial pressure this is usually due to ventricular hypertrophy.
S2 split
this is normal caused inspiration. the decreased intrathoracic pressure allows more filling of the right ventricle.
what does inspiration do to right heart sounds
increases there intensity
wide split
condition that delays the right ventricular filling. pulmonic stenosis or RBBB.
fixed split
ASD! left to right shunt, pulmonic closure greatly delayed. increased right atrial and ventricular volumes.
paradoxical split
seen in aortic prolongation. aortic stenosis or left bundle branch block. inspiration can paradoxically inhibit the split.
aortic stenosis
crescendo-decrescendo systolic ejection fraction LV»_space;aortic pressure during systole. loudest at the base, radiates to the carotids. associated with syncope, angina, dyspnea, calcifications.
mitral regurg
holosystolic, blowing high pitched. loudest at the base, and radiates to the axilla. post MI, MVP, LV dilation.
tricuspid regurg
holosystolic, blowing high pitched loudest at the tricuspid area radiates to the right sternal border. RV dilation.
mitral valve prolapse
late systolic crescendo murmur with midsystolic click. heard at the apex.
VSD
holosystolic harsh sounding at the tricuspid area.
aortic regurg
high pitched, blowing early diastolic decrescendo. hyperdynamic pulse. often due to aortic root dilation, bicuspid aortic valve, endocarditis, rheumatic.
