Murmurs

Question 1

Low pulse volume
Irregular irregular tachycardic pulse or pulsus alternans
Low pulse pressure
Elevated jugular venous pulse
Volume loaded displaced apex
Holo, pansystolic murmur to axilla, Left lateral
3rd heart sound
Effusions and Crackles
peripheral oedema
\+- poor pulses

Answer 1

Severe Mitral Regurgitation with complications of heart failure
DDx
tricuspid regurgitation but no vwaves and no pulsatile liver
VSD in a young patient

Causes include
Degenerative
IHD and LV dysfunction esp if poor pulses
Rheumatic
MVP

Severe
low volume slow rising pulse
narrow pulse pressure
Thrill
Heaving apex, undisplaced
Harsh ESM

Question 2

What are the causes of a loud S1

Answer 2

Mild MS
Hyper dynamic states
Short PR interval

Question 3

What are the causes of a soft S1

Answer 3

Mitral Regurgitation
Left bundle branch block

Question 4

What are the causes of softened heart sounds?

Answer 4

Copd
Obesity
Pericardial effusion

Question 5

Variable S1

Answer 5

AV dissociation

AF