Pathological murmurs Flashcards
What are the differentials of a pansystolic murmur?
- Mitral regurgitation
- Tricuspid regurgitation
- Ventricular septal defect
How is the pansystolic murmur caused by mitral and tricuspid regurgitation described?
High-pitched and ‘blowing’ in character
What is another term for pansystolic?
Holosystolic
How is the pansystolic murmur caused by ventricular septal defect described?
‘harsh’ in character
Where is the pansystolic murmur caused by mitral regurgitation heard?
mitral area- fifth intercostal space, mid-clavicular line
Where is the pansystolic murmur caused by tricuspid regurgitation heard?
tricuspid area- fifth intercostal space, left sternal border
Where is pansystolic murmur caused by ventricular septal defect heard?
Left lower sternal border
What causes an ejection systolic murmur that is heard loudest on expiration?
Aortic stenosis
Where is an ejection systolic murmur caused by aortic stenosis heard?
Aortic area- second intercostal space, right sternal border
What is an ejection systolic murmur caused by aortic stenosis a sign of?
obstructive hypertrophy cardiomyopathy
What causes an ejection systolic murmur that is heard loudest on inspiration?
Pulmonary stenosis
Where is an ejection systolic murmur caused by pulmonary stenosis heard?
Pulmonary area- second intercostal space, left sternal border
How is the murmur caused by patent ductus arteriosus described?
Continuous crescendo-decrescendo “machinery” murmur
How might a continuous crescendo-decrescendo “machinery” murmur affect the heart sounds?
Normal first heart sound
Murmur may continue into second heart sound
Second heart sound difficult to hear.
What does the murmur in tetralogy of fallot arise from?
Pulmonary stenosis
What type of murmur does tetralogy of fallot cause?
Ejection systolic murmur
Where is the murmur loudest in tetralogy of fallot?
At the pulmonary area (second intercostal space, left sternal border).
What conditions can cause a late systolic murmur?
- mitral valve prolapse
* coarctation of aorta
What conditions can cause an early diastolic murmur?
Aortic regurgitation
Pulmonary regurgitation
What is the name of the murmur caused by pulmonary regurgitation?
Graham-Steel murmur
How is a Graham-steel murmur/ pulmonary regurgitation described?
High-pitched and ‘blowing’ in character
What conditions can cause a mid-late diastolic murmur?
- mitral stenosis (‘rumbling’ in character)
* Austin-Flint murmur (severe aortic regurgitation )
What is an Austin-Flint murmur a sign of?
Severe aortic regurgitation
