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PANRE Review 2016 > Murmurs > Flashcards

Flashcards in Murmurs Deck (25)
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1
Q

What is the MCC of mitral stenosis? What does Mitral Stenosis Cause?
how do you treat?

A

MCC: Scarred from Rheumatic fever
Left atrium pressure increases causing transudation of fluid into the lung interstitium.
Signs of left sided heart failure(Congestive HF): wet lungs.
Manage CHF, replace valve.

2
Q

A pregnant woman who delivers while crashing with a murmur. What is this?

A

Mitral stenosis

3
Q

What is Aortic Regurge?
The signs?
What is seen on CXR and Echo

A

Results in volume overloading due to retrograde blood flow into the Left Ventricle and it has to work harder. Do not get good perfusion into the body.
Widened pulse pressure, hypoperfusion (Low BP, poor mentation), dyspnea, chest pain.
On CXR and Echo, see Thick L. Ventricle.

4
Q

What does this describe?

Tall male with chest pain (dissection) and new diastolic murmur?

A

Aortic Regurge

5
Q

Young person with exercise induced syncope with new murmur, subaortic hypertrophic myopathy underneath. What is the murmur and describe it.
How do you treat it?

A

Aortic stenosis

Needs hospital and surgery.

6
Q

Middle aged, having heart attack and develops new systolic (and diastolic) loud harsh murmur.
What has happened?
Treatment?

A

A ruptured valve leaflet or VSD developing after the MI.

Treat for acute heart failure and needs surgeon

7
Q

What is Patent Ductus arteriosus?

Murmur assoc. with it?

A

In newborn: The right side of the heart that receives oxygen poor blood from the pulmonary arteries is open to the oxygenated blood from left side of heart in the aorta and they mix.
Continuous machine like murmur.

8
Q

What type of murmurs are the worst ones?

Describe these type of murmurs?

A

Diastolic murmurs.
Either backflow across an outlet valve (pulmonic, aortic) or difficult flow across AV valve (tricuspid, mitral) so cardiac outflow is compromised. Between S2 to S1.

9
Q

What Murmur radiates to the axilla?

A

Mitral Regurge

10
Q

What is the MC acquired valve d/o in elderly assoced with HTN, hyperlipidemia, smoking?

A

Aortic Stenosis.

11
Q

What is this valve disorder: systolic ejection murmur that peaks at midsystole heard best at 2nd intercostal area with radiation to the neck and left sternal border?

A

Aortic Stenosis.

12
Q

What valve disorder has these sxs: dyspnea, chest pain, uncomfortable awareness of heartbeat, widened pulse pressure (between systolic and diastolic), laterally displaced point of maximal impulse.

A

Aortic regurgitation

13
Q

What condition has a fixed splitting of S2?

A

Atrial Septal Defect.

14
Q

What is the hallmark sound of prolapse(floppy) of the mitral valve?

A

Midsystolic click.

15
Q

S1 opening snap: Name the valve disorder?

A

Mitral Stenosis

16
Q

Murmur that is a diastolic rumble heard best at the left lower sternal margin and xiphoid, augmented during inspiration.

A

Tricuspid stenosis (right heart failure).

17
Q

Murmur that is low pitched, blowing descrescendo diastolic murmur, heard best at the 3rd intercostal space along the left sternal border.

A

Aortic regurgitation

18
Q

What murmur is heard best at the Right 2nd ICS with radiation to the neck

A

Aortic Stenosis.

19
Q

What murmur is heard best at the left lower sternal border?

A

Tricuspid Regurge.

20
Q

What murmur is heard best at the left 3rd ICS (ERBs point)?

A

Aortic Regurge.

21
Q

What is the valve disorder most commonly associated with Rheumatic Fever?

A

Mitral Stenosis

22
Q

What is the apical S4 gallop heart sound?

Causes?

A

Atrial contraction during presystole that ejects blood into a ventricle which can’t expand further.
Long standing HTN, aortic stenosis, ventricular hypertrophy, hypertrophic cardiomyopathy, early phase of myocardial infarction.

23
Q

What does the Valsalva maneuver cause in the murmur for

Aortic Stenosis and Mitral Regurge?

A

The Valsalva decreases venous return to the heart, so there is decreased blood return to the L. Ventricle. In AS, murmur gets softer since less blood is being ejected through the aortic valve. In MR, low blood volume goes across the mitral valve so the murmur is softer.

24
Q

What valve disorder has a crescendo-decrescendo heart murmur?

A

Aortic Stenosis

25
Q

What murmur has little or no radiation?

A

Mitral stenosis.