PCMI - Cardiac Cycle and Heart Sounds Flashcards
What is the mnemonic for auscultation locations of the heart? What does it mean?
All Physicians Take Money.
Aortic, Pulmonic, Tricuspid, Mitral
Where can you hear the aortic valve?
2nd intercostal space, right sternal border
Where can you hear the pulmonic valve?
2nd intercostal space, left sternal border
Where can you hear the tricuspid valve?
4th intercostal space, left sternal border
Where can you hear the mitral valve?
5th intercostal space, left mid-clavicular line
What is a murmur?
Sound produced when the flow of blood through a valve is turbulent or disrupted
When does a murmur occur?
When a valve is non-compliant, incompetent, stiff, or damaged
Does a murmur mean there is an underlying pathology?
Not necessarily
When are murmurs concerning?
When they are associated with other symptoms
How should murmurs be evaluated?
With echocardiograms
Systole is aka what 2 things?
- ) contraction
2. ) depolarization
What is SBP?
Systolic blood pressure. The pressure exerted upon the artery during heart contraction
Diastole is aka what 2 things?
- ) Relaxation
2. ) Repolarization
What is DBP?
Diastolic blood pressure. The pressure exerted upon the artery during heart relaxation
What does S1 indicate?
Closure of the AV valves
What does S2 indicate?
Closure of the semilunar valves
What is S3?
A vibratory sound that occurs from blood filling the relaxed and empty ventricle
When is it normal to hear S3?
In children and athletes
What is S4?
Atrial filling from high pressure from SVC/IVC and pulmonary venous return.
When does S4 occur?
Before S1
What is regurgitation?
Turbulent flow sound when the blood is moving in an opposite direction
What is stenosis?
Turbulent flow when blood is moving through a stiff, damaged valve
When can you hear aortic and pulmonic stenosis?
During ventricular systole
When can you hear tricuspid and mitral stenosis?
During atrial systole
What is preload?
Volume of blood sent to the heart
Does increasing preload make a murmur louder or softer?
Louder (in most cases)
Does decreasing preload make a murmur louder or softer?
Softer (in most cases)
What are the two exceptions to the rules of preload?
- ) HOCM (Hypertrophic Obstructive Cardiomyopathy)
2. ) Mitral Valve Prolapse
In HOCM, does an increase in preload improve or worsen the aortic murmur?
Improves, which is opposite of most murmurs
In HOCM, does a decreased in preload improve or worsen the aortic murmur?
Worsens, which is opposite of most murmurs
In MVP, does an increase in preload improve or worsen the aortic murmur?
Improves.
Does inspiration make right or left valve murmurs louder or softer?
Right. Louder. RINspiration
Does expiration make right or left valve murmurs louder or softer?
Left. Louder. LEXpiration
Does an increased after load make a murmur louder or softer?
Louder
Does a decreased after load make a murmur louder or softer?
Softer
What are the after load exceptions?
HOCM and MVP
Aortic stenosis is characterized by what type of murmur?
Crescendo - Decrescendo
Where is mitral regurgitation best heard?
At the apex of the heart
What kind of murmur is mitral regurgitation?
Holosystolic
What is a holosystolic murmur?
Continuing from S1 to S2
What is the general cause for tricuspid regurgitation?
IVDA
“want to TRI some drugs?”
What kind of murmur is tricuspid regurgitation?
Holosystolic
What kind of murmur is aortic regurgitation?
Early blowing diastolic murmur.
“AR, thar she BLOWS!”
What things does aortic regurgitation present with?
- Marfans (connective tissue disorder)
- Head bobbing
- Water-hammer pulse
What kind of murmur is mitral stenosis?
Opening “snap”
What causes mitral valve stenosis?
Rheumatic fever
“RheuMITRAL fever”
Mitral stenosis mnemonic
The Operating System is MicroSoft
Opening Snap is Mitral Stenosis
What kind of murmur is MVP?
Midsystolic click
“See the MVP to be the MVP and everything will CLICK”
