Podcast
Questions and Answers
What is the common cause of wide splitting of S2 in patients with primary MR?
What is the common cause of wide splitting of S2 in patients with primary MR?
Shortening of LV ejection
In patients with severe pulmonary hypertension, which heart sound is louder than A2?
In patients with severe pulmonary hypertension, which heart sound is louder than A2?
P2
What abnormality in flow rate across the mitral orifice is often associated with an S3?
What abnormality in flow rate across the mitral orifice is often associated with an S3?
Abnormal increase in the flow rate
What is the most prominent physical finding in patients with severe MR?
What is the most prominent physical finding in patients with severe MR?
What characterizes the holosystolic murmur of chronic MR?
What characterizes the holosystolic murmur of chronic MR?
What area does the holosystolic murmur of chronic MR frequently radiate to?
What area does the holosystolic murmur of chronic MR frequently radiate to?
What heart condition must the systolic murmur of chronic MR be differentiated from?
What heart condition must the systolic murmur of chronic MR be differentiated from?
What may obscure A2 in patients with severe MR?
What may obscure A2 in patients with severe MR?
What is often associated with abnormalities of the posterior leaflet in patients with MVP and flail?
What is often associated with abnormalities of the posterior leaflet in patients with MVP and flail?
What physical finding may occur in patients with severe MR and an earlier A2 as a consequence of reduced resistance to LV ejection?
What physical finding may occur in patients with severe MR and an earlier A2 as a consequence of reduced resistance to LV ejection?
What is the most common cause of wide splitting of S2 in patients with primary MR?
What is the most common cause of wide splitting of S2 in patients with primary MR?
In patients with severe pulmonary hypertension, which heart sound is louder than A2?
In patients with severe pulmonary hypertension, which heart sound is louder than A2?
What physical finding may occur in patients with severe MR and an earlier A2 as a consequence of reduced resistance to LV ejection?
What physical finding may occur in patients with severe MR and an earlier A2 as a consequence of reduced resistance to LV ejection?
What abnormality in flow rate across the mitral orifice is often associated with an S3?
What abnormality in flow rate across the mitral orifice is often associated with an S3?
What must the systolic murmur of chronic MR be differentiated from?
What must the systolic murmur of chronic MR be differentiated from?
What characterizes the holosystolic murmur of chronic MR?
What characterizes the holosystolic murmur of chronic MR?
What area does the holosystolic murmur of chronic MR frequently radiate to?
What area does the holosystolic murmur of chronic MR frequently radiate to?
What might obscure A2 in patients with severe MR?
What might obscure A2 in patients with severe MR?
What physical finding is often associated with an S3 in patients with an abnormal increase in flow rate across the mitral orifice during the rapid filling phase?
What physical finding is often associated with an S3 in patients with an abnormal increase in flow rate across the mitral orifice during the rapid filling phase?
What characterizes the holosystolic murmur of chronic MR?
What characterizes the holosystolic murmur of chronic MR?
What heart condition must the systolic murmur of chronic MR be differentiated from?
What heart condition must the systolic murmur of chronic MR be differentiated from?
In patients with severe pulmonary hypertension, which heart sound is louder than A2?
In patients with severe pulmonary hypertension, which heart sound is louder than A2?
What causes wide splitting of S2 in patients with primary MR?
What causes wide splitting of S2 in patients with primary MR?
What may occur with abnormalities of the posterior leaflet in patients with MVP and flail involving this leaflet?
What may occur with abnormalities of the posterior leaflet in patients with MVP and flail involving this leaflet?
What is often diminished in patients with primary MR and defective valve leaflets?
What is often diminished in patients with primary MR and defective valve leaflets?
What might obscure A2 in patients with severe MR?
What might obscure A2 in patients with severe MR?
What characterizes the holosystolic murmur of chronic MR?
What characterizes the holosystolic murmur of chronic MR?
What is often associated with abnormalities of the posterior leaflet in patients with MVP and flail involving this leaflet?
What is often associated with abnormalities of the posterior leaflet in patients with MVP and flail involving this leaflet?
What physical finding may occur in patients with severe MR and an earlier A2 as a consequence of reduced resistance to LV ejection?
What physical finding may occur in patients with severe MR and an earlier A2 as a consequence of reduced resistance to LV ejection?
In patients with severe pulmonary hypertension, which heart sound is louder than A2?
In patients with severe pulmonary hypertension, which heart sound is louder than A2?
What abnormality in flow rate across the mitral orifice is often associated with an S3?
What abnormality in flow rate across the mitral orifice is often associated with an S3?
What heart condition must the systolic murmur of chronic MR be differentiated from?
What heart condition must the systolic murmur of chronic MR be differentiated from?
What heart condition must the systolic murmur of chronic MR be differentiated from?
What heart condition must the systolic murmur of chronic MR be differentiated from?
What area does the holosystolic murmur of chronic MR frequently radiate to?
What area does the holosystolic murmur of chronic MR frequently radiate to?
What is often diminished in patients with primary MR and defective valve leaflets?
What is often diminished in patients with primary MR and defective valve leaflets?
Study Notes
Mitral Regurgitation (MR)
- Wide splitting of S2 in patients with primary MR is often caused by increased ventricular compliance.
- In patients with severe pulmonary hypertension, P2 is louder than A2.
- An S3 is often associated with an abnormal increase in flow rate across the mitral orifice during the rapid filling phase.
- The most prominent physical finding in patients with severe MR is a holosystolic murmur.
- The holosystolic murmur of chronic MR is characterized by a high-pitched, plateau-like murmur that radiates to the axilla or the back.
- The systolic murmur of chronic MR must be differentiated from the murmur of hypertrophic obstructive cardiomyopathy (HOCM).
- In patients with severe MR, the loud holosystolic murmur may obscure A2.
- Abnormalities of the posterior leaflet in patients with mitral valve prolapse (MVP) and flail may cause an S3.
- In patients with severe MR and an earlier A2, a reduced resistance to LV ejection may occur, leading to a shorter A2.
Mitral Valve Prolapse (MVP)
- Abnormalities of the posterior leaflet in patients with MVP and flail may cause an S3.
- In patients with MVP and flail involving the posterior leaflet, the murmur may occur due to the regurgitation.
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Description
Test your knowledge of abnormal heart sounds related to mitral regurgitation, valve leaflet defects, and pulmonary hypertension. Identify the characteristics of S1, S2, A2, and P2 sounds in different cardiac conditions.
