Heart Murmur Grading Flashcards
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Questions and Answers

What does grade 1 murmur indicate?

  • Loud murmur with palpable thrill
  • Not audible
  • Audible on careful listening (correct)
  • Faint but immediately audible

    • What does grade 2 murmur mean?

  • Audible immediately on placing the stethoscope (correct)
  • Murmur is faint but logically audible
  • Loud murmur with palpable thrill
  • Heard with rim of stethoscope touching the chest

    • What characterizes a grade 3 murmur?

  • Faint murmur
  • A loud murmur with a palpable thrill
  • Loud murmur with no palpable thrill (correct)
  • Audible only with careful listening

    • What is indicated by a grade 4 murmur?

    <p>A loud murmur with a palpable thrill</p> Signup and view all the answers

    What does grade 5 murmur suggest?

    <p>A loud murmur audible with only the rim of the stethoscope touching the chest</p> Signup and view all the answers

    What is a grade 6 murmur characterized by?

    <p>Murmur audible with the stethoscope not touching the chest</p> Signup and view all the answers

    What is a thrill?

    <p>Vibration of the skin surface caused by turbulent flow within the heart or in a peripheral vessel.</p> Signup and view all the answers

    What is a murmur?

    <p>Turbulent blood flow through valves or abnormal structures within the heart detected on auscultation.</p> Signup and view all the answers

    What is a bruit?

    <p>Turbulent blood flow heard in a peripheral vessel on auscultation.</p> Signup and view all the answers

    What does TIPPQRS stand for?

    <p>A system for describing features of a heart murmur.</p> Signup and view all the answers

    What do 'Timing' and 'Intensity' refer to in heart murmurs?

    <p>Timing refers to systolic or diastolic phases, while Intensity pertains to the loudness of the murmur.</p> Signup and view all the answers

    What are P1 and P2 in the context of heart murmurs?

    <p>P1 is the position of the stethoscope on the precordium where the murmur is heard loudest; P2 refers to the position of the patient when the murmur is heard loudest.</p> Signup and view all the answers

    What does 'Quality' mean in heart murmurs?

    <p>It refers to characteristics like being high pitched, crescendo-decrescendo, or breath-like.</p> Signup and view all the answers

    What does 'Radiation' refer to in heart murmurs?

    <p>It asks whether the murmur can be heard in related areas such as the carotids or axilla.</p> Signup and view all the answers

    What are systemic features in murmur descriptions?

    <p>These include other heart sounds, characteristics of the apex beat, pulse, etc.</p> Signup and view all the answers

    What characterizes aortic regurgitation?

    <p>Diastolic murmur with apex displaced laterally and anteriorly</p> Signup and view all the answers

    What is the quality of AR murmur?

    <p>Decrescendo diastolic along left sternal border</p> Signup and view all the answers

    What characterizes aortic stenosis?

    <p>Systolic murmur with basal systolic thrill</p> Signup and view all the answers

    How would you describe the quality of AS murmur?

    <p>Starts quietly, crescendos, then quiets</p> Signup and view all the answers

    What does mitral regurgitation typically indicate?

    <p>Systolic murmur with apical thrill</p> Signup and view all the answers

    What is the quality of MR murmur?

    <p>Radiates to axilla</p> Signup and view all the answers

    What is a characteristic of mitral valve prolapse?

    <p>Mid or late systolic click followed by a high pitched murmur</p> Signup and view all the answers

    What does mitral stenosis typically sound like?

    <p>Diastolic murmur with a tapping apex beat</p> Signup and view all the answers

    What is the quality of MS murmur?

    <p>Loud S1 - S2 with rumble</p> Signup and view all the answers

    How is tricuspid regurgitation typically described?

    <p>Systolic murmur secondary to pathology</p> Signup and view all the answers

    What characterizes TR murmur?

    <p>Holosystolic murmur increasing with inspiration</p> Signup and view all the answers

    Study Notes

    Heart Murmur Grading

    • Grade 1: Murmur only audible after careful listening.
    • Grade 2: Faint murmur immediately audible upon stethoscope placement.
    • Grade 3: Loud murmur clearly audible but without palpable thrill.
    • Grade 4: Loud murmur present with a palpable thrill.
    • Grade 5: Loud murmur with palpable thrill; audible with only the rim of the stethoscope touching the chest.
    • Grade 6: Loud murmur with a palpable thrill; audible even when the stethoscope is lifted slightly off the chest.

    Definitions of Key Terms

    • Thrill: Vibration felt on the skin surface due to turbulent blood flow.
    • Murmur: Turbulent blood flow through heart valves or abnormal structures, detected via auscultation.
    • Bruit: Turbulent blood flow audible in peripheral vessels upon auscultation.

    Murmur Descriptive System (TIPPQRS)

    • Timing: Identified as either systolic or diastolic.
    • Intensity: Generally grade 2 for quiet murmurs and grade 3 for loud; grade 1 implies expertise.
    • Position (P1): Area on the precordium where murmur is loudest.
    • Position (P2): Patient's position when murmur is loudest, mainly for diastolic murmurs.
    • Quality: Characteristics can include high-pitched, crescendo-decrescendo, or breath-like.
    • Radiation: Assessment of whether the murmur radiates to areas like the carotids or axilla.
    • Systemic Features: Consideration of other heart sounds, apex beat, and pulse characteristics.

    Specific Murmurs

    • Aortic Regurgitation:

      • Diastolic murmur.
      • Apex displacement laterally/anteriorly.
      • Palpable thrill along left sternal border and jugular notch.
      • Double systolic wave in carotids.

    • Aortic Regurgitation Quality:

      • Decrescendo diastolic murmur along the left sternal border; M1 and A2 increased.

    • Aortic Stenosis:

      • Systolic murmur.
      • Basal systolic thrill; apex displaced anteriorly/laterally.
      • Radiates to carotid artery.

    • Aortic Stenosis Quality:

      • Starts quietly, crescendos mid-systole, then quiets toward end of systole.

    • Mitral Regurgitation:

      • Systolic murmur.
      • Apical systolic thrill; apex displaced left.

    • Mitral Regurgitation Quality:

      • Apical systolic regurgitant murmur; follows decreased S1, radiates to axilla; notable S2 due to increased left ventricular end diastolic volume.

    • Mitral Valve Prolapse:

      • Common in women under 30; characterized by mid/late systolic click 0.14 seconds post S1, followed by high-pitched systolic murmur; squatting may decrease murmur.

    • Mitral Stenosis:

      • Diastolic murmur.
      • Tapping apex beat; diastolic thrill at apex; parasternal lift.

    • Mitral Stenosis Quality:

      • Loud S1 - S2; diastolic snap followed by rumble; potential atrial fibrillation; cold extremities.

    • Tricuspid Regurgitation:

      • Systolic murmur; usually secondary to another cardiac pathology.
      • Right ventricular parasternal lift; systolic thrill at tricuspid area.

    • Tricuspid Regurgitation Quality:

      • Holosystolic murmur that increases with inspiration; V wave in jugular venous pulse; systolic liver pulsation.

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    Description

    Test your knowledge on the grading system of heart murmurs with these flashcards. Each card defines a different grade from 1 to 5, providing insight into their characteristics. Perfect for medical students or anyone interested in cardiology.

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