Pulmonic Valve Stenosis

Question 1

Pulmonic valve stenosis most commonly occurs as an

Answer 1

isolated congenital defect

Question 2

Severe pulmonic stenosis is typically diagnosed _____ in life due to the development of right sided heart failure

Answer 2

early

Question 3

Severe pulmonic stenosis is typically diagnosed early in life due to the development of

Answer 3

right sided heart failure

Question 4

Patients with mild pulmonic stenosis often do not present with symptoms until

Answer 4

adulthood

Question 5

The physiologic changes of pregnancy can unmask which heart sounds

Answer 5

pulmonic stenosis

Question 6

Cardiac auscultation in pulmonic stenosis reveals a

Answer 6

pulmonic ejection click followed by a harsh crescendo-decrescendo systolic murmur best heard at the left upper sternal border

Question 7

Where is the murmur of pulmonic stenosis best heard

Answer 7

left upper sternal border

Question 8

What is the murmur of pulmonic stenosis

Answer 8

pulmonic ejection click followed by a harsh crescendo-decrescendo systolic murmur

Question 9

How does pulmonic stenosis cause splitting of S2

Answer 9

the pulmonic valve to close later than usual as it takes longer for the right ventricle to push blood through the narrowed valve which results in widened splitting of the aortic and pulmonic components of S2.

Question 10

How does inspiration affect the intensity of pulmonic stenosis

Answer 10

it increases the intensity of the murmur

Question 11

How does inspiration affect pulmonic stenosis

Answer 11

Inspiration draws additional blood into the right side of the heart, which increases the intensity of the murmur and further widens the splitting of S2

Question 12

Pulmonary hypertension causes widened splitting of S2 because

Answer 12

more time is required for the right ventricle to overcome pulmonary arterial pressure (pulmonic valve opens later and closes later)

Question 13

A benign flow murmur can occur in patients with

Answer 13

high cardiac output states (eg, pregnancy)

Question 14

A benign flow murmur can occur in patients with high cardiac output states due to

Answer 14

increased flow across the aortic and pulmonic valves

Question 15

A benign flow murmur is typically __ grade

Answer 15

low

Question 16

A bicuspid aortic valve can lead to

Answer 16

aortic stenosis in relatively young patients (those in their 50s)

Question 17

Aortic stenosis causes

Answer 17

delayed closure of the aortic valve

Question 18

Aortic stenosis causes delayed closure of the aortic valve, leading to

Answer 18

narrowed or paradoxical splitting of S2

Question 19

Hypertrophic cardiomyopathy can cause a ___ murmur

Answer 19

systolic

Question 20

Hypertrophic cardiomyopathy can cause a systolic murmur that mimics that of

Answer 20

aortic stenosis

Question 21

Hypertrophic cardiomyopathy can cause a systolic murmur that is best heard at the

Answer 21

mid-left sternal border

Question 22

In hypertrophic cardiomyopathy aortic valve closure may be delayed due to

Answer 22

prolonged ejection of blood through the left ventricular outflow tract

Question 23

A small-or-moderate sized ventricular septal defect may present in adulthood with symptoms of

Answer 23

heart failure

Question 24

Why is there widened splitting of S2 in ventricular septal defect

Answer 24

Widened splitting of S2 is due to early closure of the aortic valve (less blood is ejected into the aorta because some blood is ejected into the right ventricle).

Question 25

What murmur is heard with ventricular septal defect

Answer 25

holosystolic murmur

Question 26

Where is the murmur associated with ventricular septal defect best heard

Answer 26

left lower sternal border

Question 27

Discuss pulmonic valve stenosis

Answer 27

Pulmonic valve stenosis causes a crescendo-decrescendo systolic murmur best heard at the left upper sternal border and delays closure of the pulmonic valve, resulting in widened splitting of S2. Inspiration increases blood flow to the right side of the heart, causing increased intensity of the murmur and even later closure of the pulmonic valve.