Systolic Murmurs
congenital
what are some symptoms a patient might report rt mitral regurgitation
dyspnea, palpitations, afib
what murmur often occurs with mitral regurgitation
mitral stenosis
what murmur is usually seen with mitral stenosis
tricuspid stenosis
pt may report RUQ ABD pain and fatigue
hx of right atrial myxoma
sounds low-pitch, rumble upon auscultation
tricuspid stenosis
what are some causes to mitral regurgitation
rheumatic fever, MI, myxoma, rupture of chordae
Where may an Aortic stenosis murmur radiate to
carotid, left sternal border, and apex
state the causes of aortic insufficiency/regurgitation
rheumatic heart disease, endocarditis, aortic diseases, syphilis, dissection, cardiac trauma
what are some causes of tricuspid stenosis
congenital defect
right atrial myxoma
this murmur is secondary to pulmonary HTN or bacterial endocarditisdi
is difficult to distinguish from aortic regurg on exam
pts report progressive exertional dyspnea
pulmonic insufficiency/ regurgitation
what are some characteristics of tricuspid regurgitation upon auscultation
pansystolic
high pitch
blowing
increases with inspiration
What symptoms may a patient report with pumonic stenosis
dyspnea, cyanosis, syncope on exertion, palpitations, RHF
what does pulmonic insufficiency/ regurgitation sound like upon auscultation
high pitched at the base
what does tricuspid stenosis sound like upon auscultation
low pitch
rumble
mid-diastolic
a pt comes in complaining of coughing up blood and difficulty breathing when lying flat. upon ausculation of the lungs you hear crackles in the bases. you hear a murmur upon auscultating the heart. when listening with the bell, it sounds low-pitched and there is a rumble
mitral stenosis
state objective data of mitral regurgitation rt heart tones
decrease S1/3, S2
S3/4 gallop common late
sustained apical impulse
what are some symptoms a pt may report rt tricuspid regurgitation
fatigue, abd fullness, ankle swelling
afib/flutter
what symptoms may a pt report with mitral stenosis
dyspnea on exertion
hemoptysis
orthopnea
afib
crackles at lung bases
upon auscultation, what does aortic insufficiency sound like
high pitched
blowing
may radiate to apex
heard at the apex, often radiates to the left axilla
pansystolic, high pitched, harsh, blowing
possible thrill
positive gallop
pt has hx of rheumatic fever
mitral regurgitation
describe the objective data rt tricuspid regurgitation
right parasternal lift
S3 and thrill common
JVP has large V waves
describe the objective data rt pumonic stenosis
S1: often followed by ejection click
S2: often diminished
P2: soft or absent
S4: common
what is some objective data on aortic insufficiency/regurgitation rt heart tones
early ejection click somtimes
S1 soft
S2 split
M1/A2 often intensified
S3/4 common
list the objective data rt mitral stenosis
S1 loud followed by S2 and a loud opening snap before murmur
S2 often split with accented P2
visible lift in right parasternal area if right ventricle hypertrophied
arterial pulse amplitude increased
pts with this may report angina, syncope, and dyspnea. characteristics include early ejection click, diminished S2, and heave or sustained apical impulse.
pts might also experience JVD, hepatomegaly, and peripheral edema
Aortic Stenosis