murmurs Flashcards
what causes heart sound S1?
closing of atrioventricular valves at start of systolic contraction of ventricles
what causes heart sound s2?
closing of semilunar valves - aortic and pulmonary
S3
0.1s after S2, chordae tendinae pull full length
normal in young healthy people
older - heart failure
S4
before S1
always abnormal
stiff/hypertrophic ventricle
turbulent flow from atria contracting
where is erbs point?
3rd intercostal space left sternal border
Assessing a murmur - SCRIPT
site character - soft, blowing, crescendo, decrescendo radiation - carotids/left axilla intensity pitch timing
6 grades of murmur
1 - difficult to hear 2 - quiet 3 - easy to hear 4 - easy to hear with palpable thrill 5 - hear with stethoscope barely touching chest 6 - hear with stethoscope off chest
hypertrophy vs dilatation of myocardium
hypertrophy = thickening both outwards and into chamber dilatation = thinning and expanding
mitral stenosis can cause..
left atrial hypertrophy
aortic stenosis can cause…
left ventricular hypertrophy
mitral regurgitation can cause…
left atrial dilatation
aortic regurgitation can cause…
left ventricular dilatation
causes of mitral stenosis
rheumatic heart disease
infective endocarditis
murmur - mitral stenosis
mid-diastolic low pitched rumbling murmur
loud S1
what is mitral stenosis associated with?
malar flush
AF
what does mitral regurgitation lead to?
congestive cardiac failure
murmur associated with mitral regurgitation
pan-systolic high pitched whistling murmur
radiates to left axilla
causes of mitral regurgitation
idiopathic rheumatic heart disease infective endocarditis IHD connective tissue disorders
Most common valve disease
aortic stenosis
murmur with aortic stenosis
ejection-systolic, high pitched
crescendo-decrescendo
other signs of aortic stenosis
radiates to carotids
slow rising pulse
narrow pulse pressure
exertional syncope
causes of aortic stenosis
idiopathic - calcification
rheumatic heart disease
aortic regurg murmur
early diastolic, soft murmur
heart at the apex
corrigans pulse
collapsing pulse
aortic regurgitation
causes of aortic regurgitation
idiopathic
connective tissue disorder