Cardiac Murmurs - Step 1

jvega's version from 2017-06-01 22:24

Section 1

Question Answer
Crescendo-decrescendo systolic ejection murmur best heard in the 2nd-3rd right interspace close to the sternumAortic Stenosis
Early diastolic decrescendo murmur heard best along the left side of the sternumPulmonic Regurgitation
Late diastolic decrescendo murmur heard best along the left side of the sternumTricuspid Stenosis
Pansystolic (Holosystolic/uniform) murmur best heard at the apex and often radiates to the left axillaMitral Regurgitation
Late systolic murmur with midsystolic click (MC) best heart at apexMitral Valve Prolapse
Crescendo-decrescendo systolic murmur best heard in the 2nd-3rd left interspace close to the sternumPulmonary Stenosis
Pansystolic (Holosystolic/uniform) murmur best heard along the left lower sternal border and generally radiates to the right lower sternal borderVSD or Tricuspid Regurgitation
Rumbling late diastolic murmur with an opening snap best heard at apexMitral Stenosis
Continuous machine-like murmur (in systole & diastole) best heard at left infraclavicular area.PDA
High-pitched diastolic murmur associated with a widened pulse pressure best heard at left sternal borderAortic Regurgitation
Mid-diastolic pulmonary ejection murmurASD
Systolic heart soundsaortic/pulmonic stenosis, mitral/tricuspid regurgitation, VSD, MVP
Diastolic heart soundsaortic/pulmonic regurgitation, mitral/tricuspid stenosis.

Section 2

Question Answer
Bounding pulses, head bobbing, diastolic murmurAortic Regurgitation
Most common congenital heart murmurMitral Valve Prolapse
Weak pulsesAortic Stenosis
Heard best in the left lateral decubitus positionMitral regurgitation, Mitral Stenosis, Left Sided S3, Left Sided S4

Section 3

Question Answer
Ischemic Heart Disease, Mitral Valve Prolapse, LV dilation, Rheumatic Heart Dz, Infective EndocarditisMitral Regurgitation
RV dilation, Rheumatic Heart Dz, Infective EndocarditisTricuspid Regurgitation
Age-related (senile) calcifications, Bicuspid valve, Chronic Rheumatic Heart Dz, Congenital Unicuspid Valve, SyphilisAortic Stenosis
Myxomatous Degeneration, Rheumatic Fever, Chordae RuptureMitral Valve Prolapse (MVP)
Aortic Root dilation, Bicuspid Aortic Valve, endocarditis, rheumatic fever, Syphilis, Marfan SyndromeAortic Regurgitation
Secondary to Rheumatic Fever, Chronic MS (w/ LA Dilation)Mitral Stenosis

Section 4

Question Answer
Inspiration (↑ venous return to the right atrium)↑ intensity of right heart sounds (Tricuspid, Pulmonary)
Hand Grip (↑ afterload)↑ intensity of MR, AR, VSD murmurs, ↑ Hypertrophic Cardiomyopathy murmurs
Valsalva (phase II), standing up ( ↓ preload)↓ intensity of most murmurs (including AS), ↑ Hypertrophic Cardiomyopathy murmurs
Rapid Squatting (↑ venous return → ↑ preload & ↑ afterload)↑ intensity of AS murmur, ↓ Hypertrophic Cardiomyopathy murmurs