Murmurs

Question 1

mid-late diastolic rumble w/ an opening snap best heard at the apex

Answer 1

Mitral stenosis

RH disease, but also calcification, radiation, LA mass, iatrogenic post MV repair

Question 2

persistant flow murmur
loudest below the L clavicle
machine like murmur

Answer 2

PDA

shunt bw aorta and pulmonary artery

Question 3

mid systolic opening click at apex
high pitched, crescendo murmur

later onset and decreased time with with squatting and lateral recumbant manuever and hand squeeze

Answer 3

mitral valve prolaspe

Increases w valsalva maneuver and standing lengthens duration of murmur

Question 4

mc cause of mitral valve prolapse

Answer 4

myxomatous degeneration

Question 5

what murmur will likely occur with carcinoid syndrome

holosystolic murmur over LLSB

Answer 5

tricuspid regurg

Question 6

a pt comes in with a bp of 85/50, distant heart sounds and distention of jugular veins,
most likely dz?

Answer 6

pericardial tamponade

becks triad

Question 7

a pt comes in with sharp midsternal cp, worsens w inspiration, renal failure and DM. he has high potassium, BUN, and creatinine levels.

Answer 7

pericarditis

UREMIC

Question 8

how is infective endocarditis diagnosised?

Answer 8

blood cultures (+)

and

echo showing vegetations of cardiac valve

Question 9

wide pulse pressure
capillary pulsation in pt nail bed
head bobs w bounding pulse
blowing murmur in diastole that decreases w valsalva maneuver
Pistol shot over femoral diastolic mumrmur heard w bell over femoral a

Answer 9

aortic regurg

mc from RH of bicuspid aortic valve

Question 10

valsalva manever

Answer 10

holds breath and bears down decreases intensity of flow murmurs - APMT stenosis and regurg

hypertrophic cardiomyopathy increases intensity

Question 11

pansystolic blowing murmor over LLSB

Answer 11

VSD

commonly in trisomy 18, edwards - prominent occiput, small mouth, pointy ears, short sternum, horsehsow kidney, rocker bottom feet

also has asd and pda

Question 12

midsystolic murmur heared over LLSB

heard better if suprine

med hx unremarkable and healthy w no complaints, no cyanosis or distress

Answer 12

stills murmur

Question 13

early diastolic opening snap and diastolic rumble on LSB increases in intensity upon inspiration

Prominent a wave

Rae on ecg

Answer 13

tricuspid stenosis

Question 14

when would you hear a S3

Answer 14

vol overload

dilated cardiomyopathy

Question 15

Systolic murmur, glowing at the Apex, radiates to left axilla

Answer 15

Mitral regurgitation

Question 16

Most common acute mitral regurgitation cause

Most common chronic my mitral regurgitation cause

Answer 16

Cute - ischemic popularity muscle dysfunction, CAD, am

Chronic - mvp

Question 17

Blowing systolic murmur 4th intercostal space left sternal border, increases on inspiration, prominent the v wave in jugular venous pulse

Answer 17

Tricuspid regurgitation

Carvallo sign

Question 18

LVH
Systolic murmur,
crescendo decrescendo or second intercostal space RS border
radiates into sternal notch or carotid,
diminished as two, pulse parvus or pulses Tardes,
narrow pulse pressure,
ECG strain pattern

Answer 18

Degen calcification mc - aka calcified aortic stenosis

Aortic stenosis

Question 19

Most common… AS cardinal symptoms

Mc congenital cause of as

Answer 19

Dyspnea, angina, syncope

Bicuspid aortic valve
often and marfans in Turner syndrome

Question 20

Systolic murmur, crescendo-decrescendo 2nd to 3rd ICS LSB,

radiates to the left shoulder or clavicle

Answer 20

Pulmonary stenosis

Question 21

Holosystolic murmur, left lower sternal border with room, murmur increases with hand grip

Answer 21

Vsd

Question 22

Systolic murmur upper LSB with fixed splitting of s2

Answer 22

Asd

Question 23

diastolic, decrescendo murmur, second ICS, LBS, increased S2 from pulmonary hypertension

Answer 23

Pulmonary regurgitation