Pulmonic Valve Stenosis Flashcards
Pulmonic valve stenosis most commonly occurs as an
isolated congenital defect
Severe pulmonic stenosis is typically diagnosed _____ in life due to the development of right sided heart failure
early
Severe pulmonic stenosis is typically diagnosed early in life due to the development of
right sided heart failure
Patients with mild pulmonic stenosis often do not present with symptoms until
adulthood
The physiologic changes of pregnancy can unmask which heart sounds
pulmonic stenosis
Cardiac auscultation in pulmonic stenosis reveals a
pulmonic ejection click followed by a harsh crescendo-decrescendo systolic murmur best heard at the left upper sternal border
Where is the murmur of pulmonic stenosis best heard
left upper sternal border
What is the murmur of pulmonic stenosis
pulmonic ejection click followed by a harsh crescendo-decrescendo systolic murmur
How does pulmonic stenosis cause splitting of S2
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.
How does inspiration affect the intensity of pulmonic stenosis
it increases the intensity of the murmur
How does inspiration affect pulmonic stenosis
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
Pulmonary hypertension causes widened splitting of S2 because
more time is required for the right ventricle to overcome pulmonary arterial pressure (pulmonic valve opens later and closes later)
A benign flow murmur can occur in patients with
high cardiac output states (eg, pregnancy)
A benign flow murmur can occur in patients with high cardiac output states due to
increased flow across the aortic and pulmonic valves
A benign flow murmur is typically __ grade
low
A bicuspid aortic valve can lead to
aortic stenosis in relatively young patients (those in their 50s)
Aortic stenosis causes
delayed closure of the aortic valve
Aortic stenosis causes delayed closure of the aortic valve, leading to
narrowed or paradoxical splitting of S2
Hypertrophic cardiomyopathy can cause a ___ murmur
systolic
Hypertrophic cardiomyopathy can cause a systolic murmur that mimics that of
aortic stenosis
Hypertrophic cardiomyopathy can cause a systolic murmur that is best heard at the
mid-left sternal border
In hypertrophic cardiomyopathy aortic valve closure may be delayed due to
prolonged ejection of blood through the left ventricular outflow tract
A small-or-moderate sized ventricular septal defect may present in adulthood with symptoms of
heart failure
Why is there widened splitting of S2 in ventricular septal defect
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).
What murmur is heard with ventricular septal defect
holosystolic murmur
Where is the murmur associated with ventricular septal defect best heard
left lower sternal border
Discuss pulmonic valve stenosis
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.
