murmurs

Question 1

what causes heart sound S1?

Answer 1

closing of atrioventricular valves at start of systolic contraction of ventricles

Question 2

what causes heart sound s2?

Answer 2

closing of semilunar valves - aortic and pulmonary

Question 3

S3

Answer 3

0.1s after S2, chordae tendinae pull full length
normal in young healthy people
older - heart failure

Question 4

S4

Answer 4

before S1
always abnormal
stiff/hypertrophic ventricle
turbulent flow from atria contracting

Question 5

where is erbs point?

Answer 5

3rd intercostal space left sternal border

Question 6

Assessing a murmur - SCRIPT

Answer 6

site
character - soft, blowing, crescendo, decrescendo
radiation - carotids/left axilla
intensity
pitch
timing

Question 7

6 grades of murmur

Answer 7

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

Question 8

hypertrophy vs dilatation of myocardium

Answer 8

hypertrophy = thickening both outwards and into chamber
dilatation = thinning and expanding

Question 9

mitral stenosis can cause..

Answer 9

left atrial hypertrophy

Question 10

aortic stenosis can cause…

Answer 10

left ventricular hypertrophy

Question 11

mitral regurgitation can cause…

Answer 11

left atrial dilatation

Question 12

aortic regurgitation can cause…

Answer 12

left ventricular dilatation

Question 13

causes of mitral stenosis

Answer 13

rheumatic heart disease

infective endocarditis

Question 14

murmur - mitral stenosis

Answer 14

mid-diastolic low pitched rumbling murmur

loud S1

Question 15

what is mitral stenosis associated with?

Answer 15

malar flush

AF

Question 16

what does mitral regurgitation lead to?

Answer 16

congestive cardiac failure

Question 17

murmur associated with mitral regurgitation

Answer 17

pan-systolic high pitched whistling murmur

radiates to left axilla

Question 18

causes of mitral regurgitation

Answer 18

idiopathic 
rheumatic heart disease
infective endocarditis 
IHD
connective tissue disorders

Question 19

Most common valve disease

Answer 19

aortic stenosis

Question 20

murmur with aortic stenosis

Answer 20

ejection-systolic, high pitched

crescendo-decrescendo

Question 21

other signs of aortic stenosis

Answer 21

radiates to carotids
slow rising pulse
narrow pulse pressure
exertional syncope

Question 22

causes of aortic stenosis

Answer 22

idiopathic - calcification

rheumatic heart disease

Question 23

aortic regurg murmur

Answer 23

early diastolic, soft murmur

heart at the apex

Question 24

corrigans pulse

Answer 24

collapsing pulse

aortic regurgitation

Question 25

causes of aortic regurgitation

Answer 25

idiopathic

connective tissue disorder