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valve stenosis

stiff valve, only small opening
causes ventricular hyptertrophy

vavle regurgitation

incomplete closure of valve
causes backflow of blood


closure of mitral valve; left ventrical contraction


closure aortic valve; left vertricular pressure drops


rapid vent filling (early diastole)


atrial contraction (last diastole)

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

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


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


tricuspid etiology

Rt. vent hypertrophy, infective carditis

COPD commonly causes?

tricuspid regurg


harsh systolic murmur, louder with valsalva

diastolic murmur

sound after S2, **ALWAYS pathalogical until proven otherwise

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


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

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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