Heart Sounds and Murmurs Overview
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Questions and Answers

What is the significance of S4 heart sound?

  • May be present during pregnancy
  • Indicates normal cardiac function
  • Indicates volume overload status
  • Always pathologic, indicating stiffness of the ventricles (correct)

    • Which sign is associated with right-sided heart failure?

  • Jugular venous distension (correct)
  • Weak pulses
  • Lightheadedness
  • Pulmonary edema

    • Where is the pulmonic valve best auscultated?

  • Right second intercostal space
  • Lower left sternal border
  • Left second and third intercostal spaces near the sternum (correct)
  • At the cardiac apex

    • What condition is suggested by paroxysmal nocturnal dyspnea?

    <p>Left-sided heart failure (C)</p> Signup and view all the answers

    How should S3 be initially assessed with a stethoscope?

    <p>Using the bell (A)</p> Signup and view all the answers

    Flashcards

    Heart Sounds (S1 and S2)

    S1 is the closure of tricuspid and mitral valves, marking the start of systole; S2 is the closure of pulmonic and aortic valves, marking the end of systole. Heard using a diaphragm.

    Heart Valve Locations

    Aortic valve: right 2nd intercostal space; Pulmonic valve: left 2nd and 3rd intercostal spaces; Tricuspid valve: lower left sternal border; Mitral valve: cardiac apex.

    Heart Sounds (S3 and S4)

    S3: often a sign of volume overload, may be normal; S4: always abnormal and suggests ventricular stiffness. Heard using a bell.

    Orthopnea/Paroxysmal Nocturnal Dyspnea

    Orthopnea: shortness of breath while lying down; Paroxysmal Nocturnal Dyspnea: sudden shortness of breath waking you up at night, often relieved by sitting up or opening a window.

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    Cardiovascular Symptoms

    Differences between Right-sided and Left-sided heart failure: Right sided: neck bulging (JVD), swelling, liver enlargement; Left sided: lightheadedness, pale skin, sweating, impaired pulses, lung fluid buildup.

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    Study Notes

    Heart Sounds and Murmurs

    • S1: closure of tricuspid and mitral valves (start of systole)
    • S2: closure of pulmonic and aortic valves (end of systole)
    • Aortic valve: right 2nd intercostal space or cardiac apex
    • Pulmonic valve: left 2nd and 3rd intercostal spaces close to the sternum
    • Tricuspid valve: at or near the lower left sternal border
    • Mitral valve: at and around the cardiac apex
    • Orthopnea: shortness of breath while supine
    • Paroxysmal nocturnal dyspnea: waking up from SOB and opening a window to breathe

    Heart Valves and Conditions

    • S3: volume overload status; not always pathologic (pregnancy)
    • S4: stiffness of the ventricles; always pathologic
    • Use diaphragm for S1 and S2 for aortic and mitral regurgitation and pericardial friction rubs
    • Use bell for S3 and S4 and for murmur of mitral stenosis
    • Right sided HF: jugular venous distension (neck bulging), hepatomegaly, peripheral edema, pulmonary hypertension
    • Left sided HF: lightheaded, pallor, sweating, hair loss, weak pulses, pulmonary edema

    Pulsations and Symptoms

    • Carotid pulsations: height of pulsations unchanged by position and not affected by inspiration
    • Internal jugular pulsations: height of pulsations changes with position, rarely palpable, height falls with inspiration
    • Venous thromboembolism (VTE): includes DVT, PE
    • Aortic dissection → ripping chest pain and widened mediastinum
    • Urgent!

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    Related Documents

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    Description

    Dive into the intricacies of heart sounds and murmurs with this informative quiz. Learn about the different heart valves, their associated sounds, and conditions like heart failure. Test your knowledge on clinical signs and auscultation techniques to better understand cardiac health.

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