Murmurs Flashcards
What are the causes of acute mitral regurgitation?
- Ischemic papillary muscle dysfunction
- Ruptured chordae tendinae
- Infective endocarditis
- Volume overload increases LA pressure, pul. edema, RVF/LVD, cardiogenic shock
What are the causes of chronic mitral regurgitation? What’s the murmur?
MVP most common
MAC, myxomatous or degeneration or MAC
Systolic, blowing at apex, radiates into left axilla. Reduced S1 so use diaphragm
What kind of shock does volume overload cause?
Cardiogenic
When does the MVP murmur get louder?
Decreased ventricle volume and chamber size
This murmur increases on inspiration
Carvallo sign - Tricuspid regurg and tricuspid stenosis
Prominent v wave
Triscupid regurg
Explain the prognosis of tricuspid regurg
Typically significant only if associated with pulm HTN, lung disease, RV infarction, inferior wall MI, pacemaker
The most common etiology of aortic stenosis?
Degenerative calcification
ECG shows LVG and strain pattern with downslope of ST segment with T wave
Aortic stenosis
When you hear diminished S2 what do you think of?
Aortic stenosis
This murmur radiates to your left shoulder/clavicle at 2-3 ICS on L
Pulmonary stenosis
This murmur increases with handgrip
VSD and AR and MR
Fixed splitting of S2 involved with this murmur
ASD
What are the 3 etiologies of mitral stenosis?
- RHD associated with GAS
- Congenital
- MAC
This murmur causes hoarseness of voice, DOE, orthopnea, palpitations
Ortners syndrome
Mitral stenosis because LA pressure increases its size
Increased S1 and S2 rumbling then opening snap
Mitral stenosis
What are the 4 causes of BAV?
- Aneurysm
- IE
- Marfan’s/Turner’s
What are the 3 acute causes of Aortic Regurg?
- Infective endocarditis
- Aortic dissection
- Chest trauma
What are the 3 chronic causes of aortic regurg?
- Calcific degeneration
- BAV
- Dilated aortic root
- Rheumatic
BEAR
Where is the best place to hear the aortic regurg and hypertrophic cardiomyopathy?
3rd ICS, LSB with soft S2
Explain DeMusset’s sign, Quincke’s sign, Traube sign, and Duroziez’s sign?
AR
- DeMusset: head bob with beats
- Quincke’s sign: capillary nail pulsations
- Traube’s sign: pistol shot over femoral artery
- Duroziez’s sign: diastolic murmur over femoral artery when compressed with stethoscope bell
ASD best heard where?
2nd ICS L where P is heard
VSD best heard where?
4th ICS where Triscupid regurg and Tricuspid stenosis heard
Best place to hear pulm. regurg?
2nd ICS LSB associated with pulm. HTN, S2 increased
