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Y3 - Cardiology > Murmurs > Flashcards

Murmurs Flashcards

1
Q

When will you hear a Decrescendo early diastolic murmur?

A

Aortic regurg

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2
Q

Name signs that are associated with Aortic regurg?

A 
Corrigan’s sign 
De Musset’s sign 
Quincke’s sign 
Duroziez’s sign
Traube’s sign 
Muller’s sign
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3
Q

What is quincke’s sign?

A

pulsations are seen in the nail bed with each heartbeat when nail bed is lightly compressed

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4
Q

Austin Flint murmur is a sign of?

A

severe aortic regurg

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5
Q

What is corrigan’s sign?

A

visible distention and collapse of carotid arteries in the neck

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6
Q

Where do you hear an austin flint murmur?
How is this site different to normal aortic regurg site?

What does it sound like?

A

low pitched rumbling mid-diastolic murmur heard best at the apex (as opposed to left sternal edge)

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7
Q

What is de musset sign?

A

head bobbing with each heartbeat

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8
Q

what is duroziez sign?

A

stethoscope placed over femoral arteries. When gentle pressure is applied proximal to the stethoscope a systolic murmur is heard;

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9
Q

what is mullers sign?

A

Pistol shot’ sound heard when stethoscope placed over the femoral artery during systole and diastole

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10
Q

what is traube sign?

A

Pistol shot’ sound heard when stethoscope placed over the femoral artery during systole and diastole

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11
Q

Low-volume pulse which may be irregularly, irregular is common in which valvular disorder?

therefore which condition is common in this disorder?

A

mitral stenosis

Atrial fibrillation

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12
Q

Which disorder do you see a Mid-systolic click

Followed by a mid or late-systolic murmur

A

Mitral valve prolapse

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13
Q

which disorder do you see Large ‘v-waves’ in JVP

A

tricuspid regurg

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14
Q

Name 4 signs of right heart failure

A

Right ventricular heave
Peripheral oedema
Hepatomegaly
Ascites

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15
Q

Loud first heart sound with tapping apex beat is seen in what?

A

mitral stenosis

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16
Q

Prominent ‘a waves’ in JVP is seen when?

meaning?

A

pulmonary stenosis

and less often in tricuspid stenosis

occur because there is resistance to rt atrial contraction

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17
Q

What is the aetiology of a widely split S2 wave?

A

Widely split S2 – blood from the ventricles takes longer to pass through a narrow pulmonary valve, so pulmonary valve closure occurs much later than aortic valve closure

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18
Q

Pulmonary stenosis can cause?

Which can lead to what signs?

A

Right ventricular dilatation thus;

Right ventricular heave
Tricuspid regurgitation
Peripheral signs of right-sided heart failure

19
Q

Which murmur is associated with pulmonary regurg and cor pulmonale?

A

Graham Steell murmur - early diastolic decrescendo high pitched murmur

it is called this (as opposed to just early diastolic) when associated with mitral stenosis

20
Q

you see Raised JVP with giant ‘a waves’ when?

A

tricuspid stenosis

21
Q

Signs of pulmonary htn?

A

malar flush

graham steel murmur

right sternal heave

22
Q

4 causes of tricuspid regurg

A

Right ventricular dilatation

Rheumatic fever

Infective endocarditis

Congenital e.g. atrial septal defect,

23
Q

4 causes of aortic regurg

A

Rheumatological disorders; SLE, Rheum arthritis

Infective endocarditis

Prosthetic aortic valve failure

Connective tissue disease (e.g. Marfan syndrome, Ehlers-Danlos syndrome)

24
Q

4 causes of mitral regurg

A

Infective endocarditis

Left ventricular dilatation

Mitral valve prolapse

Connective tissue disease

25
Q

2 causes of aortic stenosis?

A

Degenerative age-related calcification (commonest cause)

Bicuspid aortic valve (important cause in a young person with aortic steno

26
Q

4 causes of mitral stenosis?

what is the most common cause?

A

Rheumatic heart disease (commonest cause of mitral stenosis worldwide)

Congenital

Left atrial myxoma (bening tumour on atrial septum)

Connective tissue disorders; marfans, ehlers danlos

27
Q

2 causes of pulmonary stenosis?

A

Congenital; Turner’s

Rheumatic fever

28
Q

Mmemonic for the 3rd heart sound?

What is the cause?

When does S3 come?

A

Kentucky

Rapid ventricular filling

After s2 (1, 23)

29
Q

Mmemonic for the 4th heart sound?

What is the cause?

When does S4 come?

A

Tennessee

Atrium contracting against a stiff ventricle (due to htn)

Just before S1 (4, 12)

30
Q

What is a summation gallop / gallop rhythm?

When do you hear it?

Sound?

A

When both 3rd and 4th heart sounds are present

End stage heart failure

Sound; 4, 123

31
Q

Intrathoric pressure drops on inspiration, what else is supposed to drop?

If this doesnt drop but rises instead, what is this sign called?

A

JVP

Kussmaul’s sign

32
Q

In which conditions do we see Kussmaul’s sign and why?

A
  1. Constrictive pericarditis
  2. restrictive cardiomyopathy
  3. cardiac tamponade

because these limit right ventricular filling due to exerting pressure

33
Q

What is the mmemonic for causes of raised jvp?

A

PQRST

34
Q

What does PQRST stand for?

  • in relation to raised jvp
A

P-Pericardial effusion, Pulmonary embolism, Pulmonary hypertension (chronic)

Q-Quantity of fluid (fluid overload)

R-Right heart failure

S-Superior venacaval obstruction
- (distended veins without pulsation)

T-Tricuspid regurgitation, Tricuspid stenosis, Tamponade (cardiac)

35
Q

Symptoms of Mitral stenosis?

A

SOB + palpitations

Malar flush
slow rising pulse
Loud 1st HS +- an opening snap

ECG:
P mitrale - bifid p wave
RVH
Atrial fibrillation

CXR:
Smaller heart?
pulmonary hypertension/ venous congestion?

36
Q

MX of Mitral stenosis?

A

Anticoagulation and treat AF

In order;

  1. Percutaneous mitral valvulostomy
  2. Open mitral valvotomy - open surgery for heavily calcified valve
  3. Replace valve with prosthesis
37
Q

Main sx of mitral regurg?

A

SOB !

PND, fatigue etc

38
Q

IVX findings of Mitral regurg?

A

ECG:
SR/AF
LVH

CXR:
Cardiomegaly
pulmonary congestion/oedema

39
Q

Mx for mitral regurg?

A

Valvular Repair, Replacement, Clipping

40
Q

hope youve realised that elevated jvp is assocaited with which valvular issues?

A

right sided - tricuspid and pulmonary

41
Q

What are cannon waves or cannon a waves and their meaning?

A

cannon atrial waves, are waves seen occasionally in the jugular vein of humans with certain cardiac arrhythmias.

When the atria and ventricles happen to contract simultaneously, the right atrium contracts against a closed tricuspid valve,

resulting in back pressure into the venous system that can be seen in the jugular venous pulse as a high-amplitude “cannon wave”

Not the same as “a waves”

42
Q

causes of cannon waves?

A

They occur irregularly in complete heart block and ventricular tachycardia,

43
Q

presentation of cannon waves?

A

may have also: headache, cough, and jaw pain

arrythmia that lead to the cannon waves; palpitation and SOB - abrupt onset?

Y3 - Cardiology (27 decks)

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