Heart Murmurs Overview

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Questions and Answers

What type of murmur is associated with aortic stenosis?

  • Rumbling or dragging
  • Continuous machine-like
  • Holosystolic
  • Crescendo/Decrescendo (correct)

Which clinical association is primarily linked to mitral regurgitation?

  • Ischemic heart disease (correct)
  • Aortic root dilation
  • Pulmonary congestion
  • Congenital rubella

How is the murmur of pulmonary regurgitation characterized?

  • Early diastolic decrescendo (correct)
  • Holosystolic
  • Systolic
  • Continuous machine-like

Where is the murmur of a ventricular septal defect (VSD) loudest?

<p>Tricuspid area (A)</p> Signup and view all the answers

What unique feature defines the murmur associated with mitral valve prolapse?

<p>Late crescendo with a midsystolic click (C)</p> Signup and view all the answers

Which symptom is NOT typically associated with aortic stenosis?

<p>Pulmonary congestion (B)</p> Signup and view all the answers

What finding is characteristic of aortic regurgitation?

<p>Pistol shot femoral pulse (B)</p> Signup and view all the answers

What auscultation finding is indicative of mitral stenosis?

<p>Rumbling or dragging following an opening snap (D)</p> Signup and view all the answers

What murmur is characterized by a mid-to-late timing and follows an opening snap?

<p>Mitral stenosis (D)</p> Signup and view all the answers

Which finding is associated with the murmur of mitral regurgitation?

<p>High-pitched 'blowing' at apex (B)</p> Signup and view all the answers

What clinical association is NOT typically linked to aortic stenosis?

<p>Ischemic heart disease (B)</p> Signup and view all the answers

What is the characteristic pattern of the murmur associated with aortic regurgitation?

<p>Early diastolic decrescendo (C)</p> Signup and view all the answers

What symptoms are most commonly associated with aortic stenosis?

<p>Syncope, angina, and dyspnea on exertion (D)</p> Signup and view all the answers

What is a notable finding in patients with a ventricular septal defect (VSD)?

<p>Holosystolic harsh murmur at tricuspid area (B)</p> Signup and view all the answers

What auscultation finding suggests that a murmur is linked with tricuspid regurgitation?

<p>Holosystolic, loudest at tricuspid area (D)</p> Signup and view all the answers

Which condition is associated with a continuous machine-like murmur?

<p>Patent ductus arteriosus (A)</p> Signup and view all the answers

What symptom is most commonly associated with mitral regurgitation?

<p>Dyspnea on exertion (A)</p> Signup and view all the answers

What is the typical feature of a ventricular septal defect (VSD) murmur?

<p>Holosystolic and harsh (A)</p> Signup and view all the answers

Which condition may predispose a patient to infective endocarditis?

<p>Mitral Valve Prolapse (A)</p> Signup and view all the answers

What characteristic finding is associated with aortic regurgitation related to pulses?

<p>Pistol shot femoral pulse (A)</p> Signup and view all the answers

Which type of murmur follows an opening snap and indicates mitral stenosis?

<p>Mid-to-late and rumbling (C)</p> Signup and view all the answers

What is the primary clinical association for aortic stenosis in young individuals?

<p>Bicuspid aortic valve (A)</p> Signup and view all the answers

What auscultation characteristic is typical of tricuspid regurgitation?

<p>Loudest at tricuspid area (C)</p> Signup and view all the answers

In aortic stenosis, what pulsation characteristic is often observed?

<p>Pulsus parvus et tardus (A)</p> Signup and view all the answers

Flashcards

Aortic Stenosis Murmur

Systolic heart murmur, crescendo-decrescendo, heard best at right upper sternal border, radiating to carotids, associated with age-related calcification or bicuspid aortic valve.

Mitral Regurgitation Murmur

Holosystolic, high-pitched blowing murmur heard best at apex, radiating towards axilla. Associated with ischemic heart disease, mitral valve prolapse, LV dilation, or rheumatic fever

Mitral Valve Prolapse Murmur

A late crescendo murmur heard at apex, loudest just before S2, often preceded by midsystolic click; usually benign but can predispose to infective endocarditis.

Aortic Regurgitation Murmur

Early diastolic, decrescendo, high-pitched blowing murmur, best heard at apex or left sternal border. Associated with aortic root dilation, bicuspid aortic valve, rheumatic fever, or endocarditis.

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Mitral Stenosis Murmur

Diastolic murmur following an opening snap (OS), characterized by a rumbling or dragging quality. Associated with rheumatic fever and can cause atrial fibrillation.

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Patent Ductus Arteriosus (PDA) Murmur

Continuous, machine-like murmur heard best in the left infraclavicular area; associated with congenital rubella or prematurity.

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Ventricular Septal Defect (VSD) Murmur

Holosystolic, harsh murmur heard at tricuspid area; a congenital heart defect.

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Pulsus Parvus et Tardus

Weak pulse with delayed peak; often associated with aortic stenosis

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What is a Systolic Murmur?

A heart murmur that occurs during the contraction of the ventricles, when blood is pumped out of the heart.

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What is Aortic Stenosis?

A narrowing of the aortic valve opening, which restricts blood flow from the left ventricle to the aorta.

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What is a Crescendo-Decrescendo Murmur?

A murmur that gradually increases in intensity (crescendo) and then decreases (decrescendo).

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What is a Holosystolic Murmur?

A murmur that is heard throughout the entire systolic phase, from the start of the heart's contraction to the end.

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What is Mitral Regurgitation?

A condition where the mitral valve does not close properly, allowing blood to leak back into the left atrium from the left ventricle.

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What is Mitral Valve Prolapse?

A condition where the mitral valve leaflets bulge backward (prolapse) into the left atrium during ventricular contraction.

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What is Aortic Regurgitation?

A condition where the aortic valve doesn't close properly, allowing blood to leak back into the left ventricle from the aorta during diastole.

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What is Mitral Stenosis?

A narrowing of the mitral valve opening, restricting blood flow from the left atrium to the left ventricle.

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Study Notes

Systolic Heart Murmurs

  • Aortic Stenosis:

    • Description: Crescendo-decrescendo murmur during systole
    • Location: Right upper sternal border, radiates to carotids
    • Causes (Elderly): Age-related calcification
    • Causes (Young): Calcification of bicuspid aortic valve
    • Associated Pulse: Pulsus parvus et tardus (weak pulse with delayed peak)
    • Symptoms: Syncope, angina, dyspnea on exertion
  • Mitral Regurgitation:

    • Description: Holosystolic, high-pitched "blowing" murmur
    • Location: Loudest at apex, radiates towards axilla
    • Causes: Ischemic heart disease, mitral valve prolapse, left ventricular dilation, rheumatic fever, infective endocarditis
  • Tricuspid Regurgitation:

    • Description: Holosystolic murmur, louder during inspiration
    • Location: Loudest at tricuspid area
    • Causes: Right ventricular dilation, infective endocarditis
  • Mitral Valve Prolapse:

    • Description: Late crescendo murmur, midsystolic click after carotid pulse
    • Location: Loudest at apex, loudest just before S2
    • Characteristics: Usually benign, can predispose to infective endocarditis
    • Causes: Rheumatic fever, chordae rupture, myxomatous degeneration
  • Ventricular Septal Defect (VSD):

    • Description: Holosystolic, harsh murmur
    • Location: Loudest at tricuspid area
    • Characteristic: Congenital
    • Note: Larger VSDs produce lower-intensity murmurs than smaller ones.

Diastolic and Continuous Murmurs

  • Aortic Regurgitation:

    • Description: Early diastolic, decrescendo, high-pitched "blowing" murmur
    • Location: Best heard at the apex (aortic root dilation), left sternal border (valvular disease)
    • Causes: Bicuspid aortic valve, endocarditis, aortic root dilation, rheumatic fever
    • Associated Pulses: Wide pulse pressure, pistol shot femoral pulse, pulsing nail bed
    • Characteristic: Hyperdynamic pulse, head bobbing, can progress to left heart failure
  • Mitral Stenosis:

    • Description: Follows opening snap, mid-to-late murmur, "2nd dub" rumbling or dragging
    • Characteristics: Decreasing interval between S2 and opening snap correlates to increased severity.
    • Causes: Sequelae of rheumatic fever
    • Complications: Left atrial dilation, pulmonary congestion, atrial fibrillation, Ortner syndrome, hemoptysis, right heart failure
    • Pressure difference: Left atrial pressure greater than left ventricular pressure during diastole
    • Opening snap: Abrupt halt in leaflet motion after rapid opening due to leaflet tip fusion in diastole.
  • Patent Ductus Arteriosus (PDA):

    • Description: Continuous, machine-like murmur
    • Location: Best heard in left infraclavicular area, loudest at S2
    • Causes: Congenital rubella, prematurity
  • Pulmonary Regurgitation:

    • Description: Diastolic murmur, after S2 and before S1
  • Pulmonary Stenosis:

    • Description: Systolic murmur

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