Valvular Heart Dz Flashcards
What is the most common cause of VHD?
myxomatous degeneration
congenital (bicuspid aortic valve)
What do stenosis and regurgitation cause to the heart?
stenosis –> pressure overload, hypertrophy and HF
regurgitation –> volume overload; dilates
When are diastolic murmors heard?
after S2 and before the next S1
What murmors are systolic (6)?
MR (mitral regurg)
TR (tricuspid regurg)
AS (aortic stenosis)
PS (pulmonic stenosis)
VSD
ASD
Which murmurs are diastolic?
AI or AR (Aortic Insufficiency or Regurg)
PI or PR (Pul insufficiency or regurg)
MS (mitral stenosis)
TS (tricuspid stenosis)
Atrial myxoma
At what murmur grade is there a palpable thrill?
4/6
What type of murmur are MR and TR?
What about MS and TS?
regurg: systolic
stenosis: diastolic
What type of murmur are AS and PS?
What about AR and PR?
Atrial/ pulmonary stenosis = systolic
regurg = diastolic
Where do you hear mitral regurg the best?
blowing at apex, radiates into left axilla
Where is mitral valve prolapse heard best?
apex
(mid-systolic click)
What causes MVP murmur to increase?
valsalva and standing
What action causes tricuspic regurg to increase in sound?
inspiration (Carvallo sign, also seen in TS)
How does the jungular venous pulse change in tricuspid regurg?
prominent V wave
Where do you hear AS?
right 2nd ICS –> radiates into sternal notch/carotids
How does AS affect S1 and S2?
diminished S2
What is the pulse pressure like in AS?
narrow (140/100)
What do you see on ECG in AS?
strain pattern = down sloping of ST segment - T wave
What does VSD sound like and where?
holosystolic
left lower sternal border w/ thrill
increases w/ handgrip
What characterizes ASD murmur?
systolic
upper LSB w/ fixed splitting of S2
How should you listen to a mitral stenosis murmur?
use bell bc low pitch
What does MS sound like?
the Operating System is MicroSoft
rumbling at apex
inc S1 and S2 –> opening snap
What is a carvallo sign?
murmur increases on inspiration
(seen in TS and TR)
What is DeMusset sign?
head bob with beats
seen in AR
What is Quincke’s sign?
capillary nail pulsations
seen in AR
What is Traube sign?
pistol shot (systolic and diastolic) sounds over femoral A
What is duroziez’s sign?
diastolic murmor over femoral A when compressed w/ bell of stethoscope
seen in AR
What does PR murmur sound like?
diastolic, decrescendo murmur
increased S2
