Systolic Murmurs Flashcards
Q: What is a systolic murmur, and during which phase of the cardiac cycle does it occur?
A: A systolic murmur occurs during the systolic phase of the cardiac cycle, specifically between the first heart sound (S1) and the second heart sound (S2).
Q: What are the two main types of systolic murmurs, and how are they classified?
A: The two main types of systolic murmurs are ejection murmurs and regurgitant murmurs. Ejection murmurs occur due to blood flow across a narrowed outflow tract (e.g., aortic stenosis), while regurgitant murmurs occur due to backward flow through an incompetent valve (e.g., mitral regurgitation).
Q: What is the characteristic finding of aortic stenosis on physical examination?
A: Aortic stenosis typically presents with a harsh, systolic ejection murmur best heard at the right second intercostal space, which may also radiate to the carotid arteries. The murmur often has a “crescendo-decrescendo” pattern.
Q: How does mitral regurgitation manifest on physical examination?
A: Mitral regurgitation is characterized by a holosystolic (or pansystolic) murmur best heard at the apex of the heart, which may radiate to the left axilla. The murmur is uniform in intensity throughout systole.
Q: What is the hallmark murmur of hypertrophic cardiomyopathy, and where is it best heard?
A: The hallmark murmur of hypertrophic cardiomyopathy is a systolic ejection murmur that is best heard along the left sternal border. It is typically characterized by a “crescendo-decrescendo” pattern and may become louder with maneuvers that decrease venous return (e.g., standing or Valsalva maneuver).
Q: How can a systolic murmur associated with ventricular septal defect (VSD) be described?
A: A murmur associated with a ventricular septal defect is typically a holosystolic (pansystolic) murmur best heard at the left lower sternal border. It results from the turbulent flow from the left ventricle to the right ventricle through the defect.
