murmurz Flashcards
crescendo-decrescendo systolic murmur
Aortic stenosis
ejection murmur
aortic stenosis
causes of aortic stenosis?
congenital and degenerative
cause of aortic regurgitation/aortic insufficiency
complication of rheumatic fever, non-rheumatic causes more common (congenital bicuspid valves, htn, endocardidis)
symptoms of aortic insufficiency
asymptomatic until middle age, then left sided failure or chest pain, exertional dyspnea, fatigue, PND, pulmonary edema, WATER HAMMER PULSE, laterally displaced PMI, bounding pulse, LV failure.
diastolic murmur along left sternal border, may be high-pitched and descrendo
aortic regurg/insufficiency
soft localized systolic murmur
may be present in aortic regurg along with diastolic murmur along left sternal border
mid-late diastolic low-pitched mitral murmur
Austin flint murmur, found in some cases of aortic regurg
Tx for aortic insufficiency
Observation, endocarditis prophylaxis, Surgery when symptoms present, afterload reduction (AcdI, nifedipine)
Cause of mitral stenosis
narrowing of mitral valve, usually caused by rheumatic heart disease; thickening of leaflets, etc. signs and sx=exertional dyspnea, orthopnea, PND, pulmonary edema or pulmonary hypertension if severe.
Opening snap following A2
mitral stenosis
localized diastolic murmur low in pitch
mitral stenosis, severity increases with the severity of stenosis
Mitral insufficiency/regurgitation
Mitral valve doesn’t close tightly, allowing backwards flow of blood, enlarged LV with larger ejection fraction but over time stress of volume reduces myocardial contractile function
Pansystolic murmur at apex radiating to axilla
Mitral regurgitation
Mitral valve prolapse
floppy valve doesn’t close tightly, significant mitral regurge, collagen abnormality.
s/sx: chest pain, palpitations, dizinnes, fatigue, connectiove tissue disorder.
No prevention: connective tissue disorder, most don’t require surery. B blockers, arrythmias, endocarditis prophylaxis.
Mid systolic clicks
Mitral valve prolapse
Pansystolic murmur or late in systole
Mitral valve prolapse
Tricuspid stenosis
Usually rheumatic, can be due to repair/replacement or carcinoid syndrome. More commin in women.
Right heart failure with HM, ascietes, edema, atrial enlargement on the right.
Liver pulsations may be present.
Tx = diuretics, prevent rheumatic fever, valve replacement
Diastolic RUMBLE along lower left sternal border
Tricuspid stenosis (can mimic mitral stenosis)
Tricuspid regurg
pressure or volume overload on right ventricle, occurs with RV dilation.
- shortness of breath, LE edema, palpitations, etc.
- treat with diuretics & treat underlying cause of regurg
S3 sound and soft holosystolic murmur along left parasternal border that increases with inspiration
Tricuspid regurgiitation
