Heart Murmur Grading Flashcards

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?

A loud murmur with a palpable thrill Signup and view all the answers

What does grade 5 murmur suggest?

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

What is a grade 6 murmur characterized by?

Murmur audible with the stethoscope not touching the chest Signup and view all the answers

What is a thrill?

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

What is a murmur?

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

What is a bruit?

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

What does TIPPQRS stand for?

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

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

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

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

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. Signup and view all the answers

What does 'Quality' mean in heart murmurs?

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

What does 'Radiation' refer to in heart murmurs?

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

What are systemic features in murmur descriptions?

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

What characterizes aortic regurgitation?

Diastolic murmur with apex displaced laterally and anteriorly Signup and view all the answers

What is the quality of AR murmur?

Decrescendo diastolic along left sternal border Signup and view all the answers

What characterizes aortic stenosis?

Systolic murmur with basal systolic thrill Signup and view all the answers

How would you describe the quality of AS murmur?

Starts quietly, crescendos, then quiets Signup and view all the answers

What does mitral regurgitation typically indicate?

Systolic murmur with apical thrill Signup and view all the answers

What is the quality of MR murmur?

Radiates to axilla Signup and view all the answers

What is a characteristic of mitral valve prolapse?

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

What does mitral stenosis typically sound like?

Diastolic murmur with a tapping apex beat Signup and view all the answers

What is the quality of MS murmur?

Loud S1 - S2 with rumble Signup and view all the answers

How is tricuspid regurgitation typically described?

Systolic murmur secondary to pathology Signup and view all the answers

What characterizes TR murmur?

Holosystolic murmur increasing with inspiration 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.