Sept 29 - Heart Murmurs Flashcards
Describe the pathophysiology of aortic stenosis.
LV works harder to overcome small diameter aorta caused by bicuspid valve (instead of 3 cusps)
State 2 facts about epidemiology of aortic stenosis.
- Doesn’t typically manifest until age 50 - 65
2. Accompanied by dilated ascending aorta
List a non-congenital cause of aortic stenosis.
Calcification associated with aging
Describe physical exam findings in aortic stenosis.
PMI will last longer and palpable thrill may be noted.
Systolic murmur best heard with diaphragm and Pt leaning forward
Why has the prevalence of aortic regurgitation decreased?
Availability of antibiotics
State the causes of aortic regurgitation.
Infective endocarditis (IV drug users), HTN, Marfan’s Syndrome (stretchy connective tissue)
State S/S of aortic regurgitation.
fatigue, exertional dyspnea, PND, atypical chest pain
When do symptoms of aortic regurgitation manifest?
Late in disease
Describe exam findings in aortic regurgitation.
Diastolic murmur over aortic area, decreased diastolic BP, LVH
State the causes of mitral stenosis
Rheumatic fever (dec bc of abx), congenital disease of chordae tendinae or papillary muscle
State the S/S of mitral stenosis.
fatigue, dyspnea, orthopnea, pulmonary HTN, A-fib in > 50% of patients
Describe exam findings in mitral stenosis.
Rumbling diastolic murmur, may note tapping sensation over PMI
State the causes of mitral regurgitation.
MI ( papillary muscles), autoimmune inflammatory disease, endocarditis, rheumatic heart disease
State S/S of mitral regurgitation.
Lt HF, pulmonary HTN, dyspnea on exertion –> often asymptomatic for many years
Describe exam findings of mitral regurgitation.
Pansystolic (throughout systole) murmur. Murmur may also occur after mid-systolic click if regurgitation is s/p mitral valve prolapse
