Pathological murmurs

Question 1

What are the differentials of a pansystolic murmur?

Answer 1

• Mitral regurgitation
• Tricuspid regurgitation
• Ventricular septal defect

Question 2

How is the pansystolic murmur caused by mitral and tricuspid regurgitation described?

Answer 2

High-pitched and ‘blowing’ in character

Question 3

What is another term for pansystolic?

Answer 3

Holosystolic

Question 4

How is the pansystolic murmur caused by ventricular septal defect described?

Answer 4

‘harsh’ in character

Question 5

Where is the pansystolic murmur caused by mitral regurgitation heard?

Answer 5

mitral area- fifth intercostal space, mid-clavicular line

Question 6

Where is the pansystolic murmur caused by tricuspid regurgitation heard?

Answer 6

tricuspid area- fifth intercostal space, left sternal border

Question 7

Where is pansystolic murmur caused by ventricular septal defect heard?

Answer 7

Left lower sternal border

Question 8

What causes an ejection systolic murmur that is heard loudest on expiration?

Answer 8

Aortic stenosis

Question 9

Where is an ejection systolic murmur caused by aortic stenosis heard?

Answer 9

Aortic area- second intercostal space, right sternal border

Question 10

What is an ejection systolic murmur caused by aortic stenosis a sign of?

Answer 10

obstructive hypertrophy cardiomyopathy

Question 11

What causes an ejection systolic murmur that is heard loudest on inspiration?

Answer 11

Pulmonary stenosis

Question 12

Where is an ejection systolic murmur caused by pulmonary stenosis heard?

Answer 12

Pulmonary area- second intercostal space, left sternal border

Question 13

How is the murmur caused by patent ductus arteriosus described?

Answer 13

Continuous crescendo-decrescendo “machinery” murmur

Question 14

How might a continuous crescendo-decrescendo “machinery” murmur affect the heart sounds?

Answer 14

Normal first heart sound
Murmur may continue into second heart sound
Second heart sound difficult to hear.

Question 15

What does the murmur in tetralogy of fallot arise from?

Answer 15

Pulmonary stenosis

Question 16

What type of murmur does tetralogy of fallot cause?

Answer 16

Ejection systolic murmur

Question 17

Where is the murmur loudest in tetralogy of fallot?

Answer 17

At the pulmonary area (second intercostal space, left sternal border).

Question 18

What conditions can cause a late systolic murmur?

Answer 18

• mitral valve prolapse

* coarctation of aorta

Question 19

What conditions can cause an early diastolic murmur?

Answer 19

Aortic regurgitation

Pulmonary regurgitation

Question 20

What is the name of the murmur caused by pulmonary regurgitation?

Answer 20

Graham-Steel murmur

Question 21

How is a Graham-steel murmur/ pulmonary regurgitation described?

Answer 21

High-pitched and ‘blowing’ in character

Question 22

What conditions can cause a mid-late diastolic murmur?

Answer 22

• mitral stenosis (‘rumbling’ in character)

* Austin-Flint murmur (severe aortic regurgitation )

Question 23

What is an Austin-Flint murmur a sign of?

Answer 23

Severe aortic regurgitation