Cardiac Murmurs

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Author:
Mat
ID:
66316
Filename:
Cardiac Murmurs
Updated:
2011-08-22 07:12:54
Tags:
cardiac
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Description:
Systolic, diastolic, and continuous murmurs
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  1. Name all the diastolic murmurs
    • Pulmonic regurgitation
    • Mitral stenosis
    • Tricuspid stenosis
  2. Name the Continuous murmurs
    • PDA
    • Mammary soufle
  3. Name the systolic murmurs
    • Aortic stenosis
    • Bicuspid aortic valve
    • Pulmonic stenosis
    • HOCM
    • Mitral regurgitation
    • MVP with mitral regurgitation
    • Papillary muscle dysfunction or rupture
    • Atrial septal defect
    • VSD
    • Tricuspid regurgitation
    • Innocent flow murmur
  4. Define pulsus parvus
    A pulse of small amplitude
  5. Define Pulsus parvus et tardus
    a small pulse with low pressure that rises and falls gradually. The condition occurs in aortic stenosis.
  6. Define Pulsus paradoxus
    an abnormal inspiratory decrease in arterial blood pressure,
  7. Crescendo-decrescendo, midsystolic murmur located at the base and radiates to the carotids, characterized by single S2, pulsus parvus, S4, palpable apical
    impulse
    Aortic stenosis
  8. Crescendo-decrescendo, midsystolic murmur located at the base, no radiation
    Pulmonic Stenosis
  9. Crescendo, mid- or late systolic murmur located at the base, radiates to the carotids. Bifid carotid pulse. Murmur decreases with passive leg elevation or hand grip, increased with valsalva
    HOCM
  10. Holo- or late systolic murmur. located at the apex, and radiates to the axilla or back
    Mitral regurgitation
  11. Late systolic murmur located at the apex, radiates to the axilla. With Valsalva, murmur decreases and midsystolic cllick moves closer to S1
    Mitral valve prolapse with mitral regurgitation
  12. Crescendo-decrescendo, midsystolic murmur located at the Base, and radiating to the Carotids
    Bicuspid aortic valve
  13. Holosystolic murmur at the LLSB, no radiation. Palpable thrill; murmur increases with isometric exercise, decreases with amyl nitrate
    Ventricular septal defect
  14. Holosystolic murmur located at the LLSB, radiates to the LRSB. Prominent v waves in neck, hepatic pulsation; murmur increases with inspiration; in severe TR, abdominal ascites, pedal edema; with pulmonary hypertension, loud pulmonic component of S2
    Tricuspid regurgitation
  15. Decrescendo diastolic murmur at LLSB, no radiation. Enlarged apical impulse, widened pulse pressure, bounding carotid pulses; murmur best heard in upright position, leaning forward, end-expiration
    Aortic regurgitation
  16. Mid-diastolic murmur at the LLSB, no radiation. Loud S2 if pulmonary hypertension is present
    Pulmonic regurgitation
  17. Low-pitched diastolic rumble at the apex, no radiation. Murmur best heard in left lateral decubitus position; opening snap; palpable P2; irregular pulse if atrial fibrillation is present
    Mitral stenosis
  18. Low-pitched diastolic rumble at the LLSB, radiates to the RUQ, characterized by a right ventricular heave
    Tricuspid stenosis
  19. Machinery-like continuous at the base, radiates to the back. May have widened pulse pressure
    Patent ductus arteriosus
  20. Soft, humming continuous murmur, located between breast and sternum, no radiation.
    Mammary souffle
  21. Accentuation midsystole, but continuous, located over back, radiates to the back. Characterized by higher blood pressure in arms versus legs
    Coarctation of the aorta
  22. Right ventricular impulse, fixed splitting of the S2, a pulmonary mid-systolic murmur and a trucuspid diastolic flow rumble
    ASD
  23. Describe the physical findings in ASD.
    Right ventricular impulse, fixed splitting of the S2, a pulmonary mid-systolic murmur and a trucuspid diastolic flow rumble
  24. Describe physical exam findings in HOCM
    • dynamic systolic murmur that increases with Valsalva maneuver release.
    • The apical impulse is often displaced and bifid.
    • A parasternal impulse would not be expected, and the S2 should be normal.
    • The electrocardiogram in patients with hypertrophic cardiomyopathy demonstrates left ventricular hypertrophy.
  25. Physical exam findings in a pt with pulmonary arterial HTN
    • parasternal impulse and a loud pulmonic component of the S2, which changes with respiration.
    • The electrocardiogram in patients with pulmonary arterial hypertension demonstrates features of right axis deviation, right ventricular hypertrophy with tall R waves in the right precordial leads (V1 and V2) and deep S waves in the left precordial leads (V5 and V6), and, occasionally, a right ventricular strain pattern.
  26. Describe the physical exam findings in pts with rheumatic heart disease
    • loud S1, variable S2, and an opening snap, followed by a low-pitched diastolic murmur.
    • In the setting of concomitant pulmonary hypertension: the S2 is loud and splits during inspiration but does not remain split during expiration.
    • The electrocardiogram in patients with mitral stenosis demonstrates features of left atrial enlargement and hypertrophy.
    • When pulmonary hypertension occurs, right ventricular hypertrophy is also demonstrated.
  27. Characteristic features of what valve defect include a prominent a wave in the jugular venous pulse contour, a parasternal impulse, an ejection click, a systolic thrill, and an early systolic murmur that increases with inspiration.
    Pulmonary valve stenosis
  28. What are the characteristic features of pulmonary valve stenosis?
    Characteristic features of pulmonary valve stenosis include a prominent a wave in the jugular venous pulse contour, a parasternal impulse, an ejection click, a systolic thrill, and an early systolic murmur that increases with inspiration.

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