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Murmurs > Murmurs > Flashcards

Murmurs Flashcards

1
Q

Common systolic murmurs

A

Aortic stenosis & Mitral Regurg/Insuff.

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2
Q

Common diastolic murmurs

A

Mitral stenosis & Aortic Regurg/Insuff.

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3
Q

7 qualities to describe a murmur

A
  1. Timing
  2. Intensity
  3. Shape
  4. Location
  5. Pitch
  6. Quality
  7. Radiation
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4
Q

Murmur Grade characteristics & when do you hear thrills?

A 
I. Faint
II. quiet but heard immediately
III. moderately loud
IV. loud
V. hear with steth partly off chest
VI. No steth needed
***Thrills associated with IV or >
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5
Q

Pitch descriptions & then quality

A

Pitch-high med low

Quality - blowing, harsh, rumbling, musical

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6
Q

What is stenosis?

A

Thickening or blocking of valve leaflets

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7
Q

Systolic murmur types and what is the etiology/anatomical cause with each?

A

Increased turbulence associated w/…

  • Ejection murmur: flow across abnormal SL valve or narrowed outflow
    ex: Aortic Stenosis
  • Holosys. Murmur: incompetent AV valve
    ex: mitral reg/insuff
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8
Q

Mid systolic ejection murmurs:

  • what is common “shape”
  • when innocent
  • physiolog. reasons
  • Pathologic causes
A
  • cresc/decresc
  • innocent w/ children/young adults
  • physio anemia, preg, fever, hyperthyr
  • Patho: AS, hypertrophic CM, Pulmon Stenosis
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9
Q

Aortic stenosis causes

A
  • Degenerative/Age>65
  • Bicuspid valve (1% babies)
  • Rheumatic
  • Atherosclerosis
  • Irradiation or collagen vascular disease
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10
Q

Symptoms of AS presenting

A
  • Most asymptomatic
  • 50% present with CHF
  • 35% w/ angina
  • 15% w/ syncope
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11
Q

Treatment of AS

A
  • Asymptomatic: no competitive athletics, echo every 2-5 years
  • Symptomatic: valve replacement for severe disease…symptomatic AS is lethal
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12
Q

Where is AS heard best and does it radiate?

A

-Heard best 2nd IC space on right chest and radiates to carotids

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13
Q

MC holosystolic murmur

A

Mitral regurg or insufficiency. Can also be tricuspid regurgitation or VSD

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14
Q

Mitral valve regurgitation/insufficiency cause

A

Primary - leaflet, annular, or chord/papillary abnormalities

Secondary - LV dilation, Ischemic heart disease, MVP, infectious endocarditis

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15
Q

Symptoms of mitral valve regurgitation/insufficiency

A 
exercise intolerance
palpitations
angina
dyspnea
A-fib
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16
Q

where do you hear mitral valve regurgitation/insufficiency best and radiate

A

Apex
radiate to axilla/back or base of heart
***usually has systolic thrill, soft s3

17
Q

Rumbling diastolic murmur vs. early decrescendo diastolic

A

mitral stenosis vs. aortic regurgitation

18
Q

Mitral stenosis cause & main symptoms

A

Rheumatic fever & RHD

Palpitations, hoarseness from recurrent laryngeal nerve impingement, and a-fib

19
Q

Mitral stenosis txt

A
  • yearly echo
  • BB or CCB to decrease HR and left atria pressure
  • Valve replacement in severe disease
  • A-fib therapy
20
Q

MS: when in heart sounds, pitch, best heard, and radiation?

A
  • mid diastolic
  • low pitch
  • Apex
  • no radiation/little
21
Q 
Aortic Regurgitation:
-where heard best
what pitch
shape
when in heart cycle
quality
radiation
A
  • 2nd/3rd ICS left sternum
  • high pitch
  • decrescendo
  • early diastole
  • blowing quality
  • radiate to sternal boarder
22
Q

Continuous murmurs:

  • when do they start and end
  • 3 common examples
A

-systole to all or part of diastole
-PDA - has harsh quality
Venus hum: abolished by compression over IJV or turning head
-Pericardial friction rub (scratchy)

23
Q

PDA shape, timing and what is the ductus artery

A
  • cres/decres
  • both systole and diastole
  • artery in fetus that connects pulmonary artery to aorta that usually collapses and then can fibrose
24
Q

Left lateral position to auscultate for…

A

Mitral/Tricuspid murmurs

25
Q

Lean forward for ….

A

aortic and pulmonic murmurs

26
Q

Standing will accentuate which murmurs and soften which murmur

A
  • Accentuate MVP and hypertrophic cardiomyopathy

- soften AS

27
Q

Squatting/valsalve will accentuate which murmur and soften which murmurs

A
  • Accentuate AS

- Soften MVP and hypertrophic cardiomyop

Murmurs (1 decks)

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