VII. Cardiac Murmurs Flashcards
Grade 3/6 systolic murmur, blowing on the upper left 2nd ICS, widely split S2
ASD (note: 1. systolic ejection blowing murmur - sound made when blood is trying to get out o a narrow valve (stenosis), 2. L upper 2nd ICS - location of Pulmonic valve on auscultation—- number 1+2 = PULMONIC VALVE STENOSIS (In ASD, there is PV stenosis is due to increased blood flow passing through R chambers and into the PA) ; 3. widely split S2 - RBBB)
Grade 2-5/6 systolic REGURGITANT murmur at left lower sternal border; S2 loud and single
VSD (note: 1. regurgitant murmur - sound made when there is passage of blood from high pressure to lower pressure (LV to LA); 2. Left lower sternal border - location of the LEFT VENTRICLE which is overworked in VSD; 3. S2 loud and single - when Pulmonary HTN is present)
Continuous machinery like murmur at the 2nd left infraclavicular area
PDA (note: 1. machinery sound is produced by the significant pressure gradient between the pulmonary artery and the aorta; 2. 2nd Left infraclavicular area - location of the PDA in the aorta)
Single and loud S2, no murmur in intact ventricular septum
Transposition of Great Arteries (note: S2 loud and single - when Pulmonary HTN is present)
Grade 3-5/6 systolic ejection murmur at the mid and left upper sternal border with RADIATION TO THE BACK; single S2; RV tap on the left sternal border
TOF (note: 1. systolic ejection blowing murmur - sound made when blood is trying to get out o a narrow valve (stenosis), 2. L upper 2nd ICS - location of Pulmonic valve —- PULMONIC VALVE STENOSIS (component of TOF due to anterior and superior displacement of the VSD blocking flow to the PA) 3. Radiation to the back - differentiates between pulmonic stenosis seen in ASD), 4. Single S2 - pulmonary hypertension)
Systolic regurgitant murmur at the left lower sternal border; systolic ejection murmur at the left upper sternal border
Tricuspid Atresia (note: It has 3 components: Pulmonic stenosis, ASD, and VSD: 1. systolic ejection blowing murmur at the L upper 2nd ICS —— PULMONIC STENOSIS ——ASD 3. systolic regurgitant murmur at left lower sternal border ———- VSD)
Early systolic ejection click at the left sternal border; systolic regurgitant murmur at the left lower sternal border; S2 heart sound loud and single
Truncus Arteriousus (note: It has a large VSD: 1. Systolic regurgitant murmur at left lower sternal border ———- VSD 2. Single S2 - produced by the truncal valve
Systolic ejection murmur at the left upper sternal border (or LSB) or no murmur at all
TAPVR (note: It has an ASD: 1. systolic ejection blowing murmur at the L upper 2nd ICS - ASD)
systolic ejection murmur at the mid and left upper sternal border with RADIATION TO THE BACK; soft p2
Pulmonic stenosis
Harsh systolic ejection murmur at the R upper sternal border; Systolic thrill heard at the suprasternal notch
Aortic stenosis (note: 1. systolic ejection blowing murmur - stenosis 2. R upper sternal border - location of the aortic valve on ausculation)
Loud S1 at the apex, narrowly split S2 with loud P2; Opening snap followed by low frequency mitral diastolic rumble at the apex
Mitral stenosis (note: 1. APEX - location of the mitral valve on auscultation 2. opening snap - stenosis 3. Loud S1, narrowly split S2 with loud P2 - pulmonary hypertension)
Systolic regurgitant murmur grade 2-4/6 at the apex with transmission to the L axilla (or left lower sternal border with radiation to the left antertior axillay line); short low frequency diastolic rumble at the apex
Mitral Regurgitation (note: 1. APEX - location of the mitral valve on auscultation 2. left lower sternal border with radiation to the left antertior axillay line - think MITRAL REGURGITATION)
Systolic ejection murmur at the 2nd left ICS with RADIATION to the interscapular area
Coarctation of the Aorta
Hyperdynamic precordium; diastolic thrill at the 3rd-4th left ICS; wode pulse pressure; bounding water hammer pulse
Aortic regurgitation
Late systolic click associated with high pitched late systolic murmur
Mitral valve prolapse
