murmurs and associated conditions

Question 1

S1 heat sound

Answer 1

• Closing of AV valves at start of contraction (tricuspid and mitral)
• Lub sound

Question 2

S2 heart sound

Answer 2

• Closing of aortic and pulmonary valves for diastole
• Dub sound

Question 3

S3 heart sound

Answer 3

• Blood rushing back to ventricles during diastole

Path - can indicate LVF (dilated cardiomyopathy), mitral regurgitation

Question 4

S4 heart sound

Answer 4

• Just before S1 (coincides with P wave) - always pathological
• Sudden flowing of blood into ventricles as atrium contracts - overcoming stiff ventricles
• Heard in aortic stenosis and HCOM

Question 5

Mitral stenosis

Answer 5

• Mitral valve doesn’t fully open, LA has to work harder to pump out blood leading to LA hypertrophy
• Mid diastolic, low pitched rumbling murmur
• Loud S1
• Malar flush and atrial fibrillation

Question 6

Mitral regurgitation

Answer 6

• Incompetent mitral valve and so blood leaks back to LA causing LA dilation
• caused by infective endocarditis, rheumatic heart disease, age related weakness, mafans syndrome
• Pan/holo systolic high pitched murmur

Question 7

Aortic stenosis

Answer 7

• Aortic valve becomes narrowed, causing LV hypertrophy
• Infective endocarditis, rheumatic heart disease, calcification,
• Ejection systolic murmur, high pitched, crescendo-decresendo (burrrr dub)
• Slow rising pulse, narrow pulse pressure (systolic and diastolic close together), symptoms of syncope

Question 8

Aortic regurgitation

Answer 8

• Aortic valve incompetence and so blood leaks back to LV causing dilation
• Age related weakness, rheumatic heart disease, infective endocarditis, marfans syndrome
• Early diastolic soft/blowing murmur (lub tarrr)
• Collapsing pulse and soft S2