Murmurs and such Flashcards
Thready carotid pulses
aortic stenosis
Bounding pulses/widened pulse pressures
aortic regurg
Left sided atrial enlargement and ventricular hypertrophy on CXR
Aortic valve disorders
Atrial enlargement alone on CXR
Mitral valve disorders
2nd right intercostal space
Aortic stenosis
Apex
Mitral stenosis and regurg
2nd-4th left intercostal space
Aortic regurgitation
Radiates to neck and LSB
Aortic stenosis
Radiates to left axilla
Mitral regurg
Radiates to apex and RSB
Aortic regurgitation
No radiation
Mitral stenosis
Holosystolic
Mitral regurg
Tricuspid regurg
Diastolic decrescendo blowing
Aortic regurg
Diastolic rumble
Mitral stenosis
Systolic crescendo-decrescendo
Aortic stenosis
Harsh midsystolic ejection cresc-desrescedo
Pulmonic stenosis
Left lower sternal boarder
Tricuspid regurgitation
2nd-3rd left intercostal space
Pulmonic stenosis
Radiate to right sternum and xiphoid area
Tricuspid regurg
Radiate to left shoulder and neck
Pulmonic stenosis
____ murmurs are intensified when pts sit up and lean forward
Aortic
____ murmurs are intensified when pts lay on LEFT side
Mitral
Squatting/leg raise/laying down increase ___ murmurs
All murmurs (increase venous return) EXCEPT hypertrophic cardiomyopathy and MVP
Squatting/leg raise/laying down decrease ___ murmurs
hypertrophic cardiomyopathy and MVP
Valsalva/standing increase ___ murmurs
hypertrophic cardiomyopathy and MVP
Valsalva/standing decrease ___ murmurs
All murmurs (decrease venous return) EXCEPT hypertrophic cardiomyopathy and MVP
Inspiration increase venous return to (right/left) side
right –> right sided murmurs (pulmonic/tricuspid) best heard w/ inspiration
Expiration increase venous return to (right/left) side
left –> left sided murmurs (aortic/mitral) best heard w/ expiration
Hand grip decreases ___ murmurs
AS
MVP
Hypertrophic cardiomyopathy
Hand grip increases ___ murmurs
AR, MR (d/t increased backward flow)
MS (d/t increased afterload)
Hand grip (increases/decreases) afterload and (increases/decreases) backward flow
increases, increases
Amyl nitrate (increases/decreases) afterload and (increases/decreases) backward flow
decreases, decreases
Amyl nitrate increases ___ murmurs
AS
MVP
Hypertrophic cardiomyopathy
Amyl nitrate decreases ___ murmurs
AR, MR
Widely split fixed S2
ASD
MC cause of paradoxical S2 split
Left bundle branch block
Paradoxical split = occurs w/ expiration, disappears w/ inspiration
Aortic Stenosis: (Wide/narrow) pulse pressure
Narrow
Aortic Regurgitation: (Wide/narrow) pulse pressure
Wide
pulsus parvus et tardus =
Seen in ___
Weak, delayed pulse
Aortic stenosis
PDA: (Wide/narrow) pulse pressure
Wide
Bounding peripheral pulses
(Wide/narrow) (paradoxical/ fixed) split S2 and Grade II/VI (diastolyic/systolic) mumur heard at ____ in Atrial Septal Defect
WIDE FIXED split S2 SYSTOLIC heart over PULMONIC REGION
(Wide/narrow) (paradoxical/ fixed) split S2 and Grade III/VI HOLO(diastolyic/systolic) mumur heard at ____ in Ventricular Septal Defect
WIDE FIXED split S2 and Grade III/VI HOLOSYSTOLIC mumur heard at LEFT STERNAL BORDER in Ventricular Septal Defect
Opening snap associated with ___
Mitral stenosis