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valve stenosis

stiff valve, only small opening
causes ventricular hyptertrophy

vavle regurgitation

incomplete closure of valve
causes backflow of blood

S1

closure of mitral valve; left ventrical contraction

S2

closure aortic valve; left vertricular pressure drops

S3

rapid vent filling (early diastole)
Kentucky

S4

atrial contraction (last diastole)
Tennessee

aortic valve heard

right upper sternal border

pulmonic valve heard

left upper sternal border

tricuspid valve heard

lower left sternal border

mitral valve heard

apex (same place at V5&6 lead placement)

Systolic murmurs

MR ASS
mitral regurg, aortic stenosis

Aortic stenosis sound and quality

crescendo-decrescendo, harsh

aortic stenosis radiates to

neck and apex

Most common significant murmur

aortic stenosis

Etiology of Aortic stenosis

Congenital, clacified valve, rheumatic

Sx of aortic stenosis

angina, syncope, CHF

Pulmonic stenosis sound and quality

crescendo-decrescendo, maybe harsh

pulmonic stenosis radiates to

neck and shoulder

etiology of pulmonic stenosis

congenital

Mitral regurgitation sound and quality

holosystolic, high pitched and blowing

mitral regurg. radiates to

left axilla

etiology of mitral regurg

MI, rheumatic, ruptured cordae

sx of mitral regurg

pulm edema, low ejection fraction

Tricuspid regurg sound and quality

holosystolic, high pitched and harsh

tricuspid regurg radiates to

precordium

tricuspid etiology

Rt. vent hypertrophy, infective carditis

COPD commonly causes?

tricuspid regurg

IHSS

harsh systolic murmur, louder with valsalva

diastolic murmur

sound after S2, **ALWAYS pathalogical until proven otherwise
ARMSD

Aortic regurg sound and quality

decrescendo, bounding pulse

etiology aortic regurg

rheumatic, infective endocarditits, HTN, aortic root dz

What type of murmur is seen in Marfans'?

Aortic regurgitation

sx aortic regurg

exertional dyspnea, fatigue

pulmonic regurg sound

decrescendo

etiology pulmonic regurg

pulm HTN

Mitral stenosis sound and quality

dcrescendo-crescendo, loud S1

etiology of mitral stenosis

rheumatic, calcifcation, congenital, collagen vasc. dz

sx of mitral stenosis

exertional dyspnea, orthopnea, hemoptysis

tricuspid stenosis sound and quality

rumble with inspiration

etiology of tricuspid regurg

rheumatic, carcinoid dz, h/o valve repair

sx of tricuspid regurg

Rt. HF, hepatomegaly, ascites, dependent edema

continous murmers

patent ductus arteriosus, venous hum, coarctation of aorta

Infective endocarditis

infection of endocardial lining and valves

what bacteria often cuases infective endocartditis

strep
staph in IV drug users

Risks for infective endocarditis

congenital malformation of valve, h/o surgery, IV drug use, venous or urinary cathater

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