Systolic Murmurs (5 star!!)

Question 1

6 systolic murmurs

Answer 1

1/2. mitral or tricuspid stenosis
3/4. Aortic or pulmonic stenosis
5. VSD
6. mitral valve prolapse

Question 2

crescendo-decrescendo systolic murmur following ejection click

Answer 2

aortic stenosis

*ejection click due to abrupt halting of valve leaflets

Question 3

where does aortic stenosis murmur radiate

Answer 3

carotids or heart base

Question 4

MCC of aortic stenosis

Answer 4

bicuspid aortic valve

Question 5

2 other causes of aortic stenosis beside bicuspid valve

Answer 5

1. chronic rheumatic valve dz
2. Syphilis

*could also be a cong. unicuspid valve

Question 6

3 symptoms aortic stenosis can lead to

Answer 6

1. syncope
2. angina (chest pain w/ exertion)
3. dyspnea on exertion

• “SAD”

Question 7

characteristic sign of aortic stenosis

Answer 7

pulsus parvus et tardus

Question 8

holosystolic harsh sounding murmur heard best at tricuspid area

Answer 8

VSD

Question 9

what can accentuate a VSD murmur

Answer 9

hand grip and inspiration

• heard best in tricuspid area

Question 10

late systolic crescendo murmur

Answer 10

mitral valve prolapse

Question 11

what noise is heard with MVP

Answer 11

midsystolic click! (due to tensing of chordae tendinae)

Question 12

3 causes of MVP

Answer 12

1. myxomatous degeneration
2. rheumatic fever
3. chordae rupture

Question 13

what can enhance MVP murmur

Answer 13

standing or valsalva–> anything that enhances venous return

Question 14

holosystolic, high-pitched “blowing murmur”

Answer 14

mitral or tricuspid regurgitation

*these immediately follow S1–> aortic stenosis and MVP both have start a little after S1

Question 15

holosystolic, radiates to right sternal border

Answer 15

tricuspid regurgitation

Question 16

holosystolic, radiates toward axilla

Answer 16

mitral valve regurgitation

Question 17

MCC of mitral regurgitation

Answer 17

rheumatic heart dz

Question 18

2 other causes of mitral regurg other than the MC

Answer 18

1. ischemic heart dz

2. left ventricular dilation

Question 19

IV drug users usually cause what kind of valvular damage and which one

Answer 19

tricuspid regurgitation–> infective endocarditis from dirty drugz

Question 20

enhances mitral regurg

Answer 20

hand grip or squatting (increased SVR)

Question 21

enhances tricuspid regurg

Answer 21

inspiration (increases venous return)

Question 22

MC valvular lesion

Answer 22

MVP

Question 23

aortic stenosis at around age 40–> cause?

Answer 23

biscuspid aortic valve

Question 24

aortic stenosis after age 60?

Answer 24

senile degenerative calcification

Question 25

RV dilation can cause

Answer 25

tricuspid regurgitation