EKG/Murmurs

Systolic Murmurs

100

Best heart 2nd intercostal parasternal 

"crescendo-decrescendo" "harsh/rough" murmur 

AORTIC STENOSIS 

200

Radiates from the apex to the axilla 

Late in disease causes JVD, hepatomegaly 

MITRAL VALVE REGURGITATION 

300

Located upper left sternal border 2nd intercostal 

PULMONIC STENOSIS 

400

What physiologic changes happen to the heart with MR?

Dilation - can lead to A fib

R side involvement - A flutter 

500

Late systolic crescendo with a mid systolic click 

Mitral valve prolapse 

Diastolic Murmurs

100

Commonly due to rheumatic heart disease. 

Mitral stenosis 

200

Best heard when leaning forward, causes bounding pulse , wide pulse pressure 

Aortic regurgitation 

300

Best heard at apex, left lateral decubitus position with bell, S1 with opening snap then mid-diastolic rumbling murmur

Mitral Stenosis 

400

Aortic regurgitation and ___ are both heard in left sternal border 2nd intercostal.

Pulmonic regurgitation 

500

Known as Graham Steel murmur

Pulmonic Regurgitation 

Name that rhythm

100

SA and AV node switch, regular rhythm 

Differently p morphology (almost in every beat)

60-100 bpm 

Normal in children 

Wandering Atrial Pacemaker 

200

PR interval constant -> QRS dropped

Can be regular/irregular 

Second degree type II

300

Saw tooth appearance

Rate 250-350 

A flutter 

400

Rate 40-60 

P waves can be present, hidden or right next to QRS

Can be lethal 

QRS normal 

Junctional Escape rhythm

Only difference between this rhythm and accelerated junctional (60-100) and junctional tachycardia (100-180) is heart rate. 

500

Heart rate 20-40

Absent p waves 

WIDE QRS 

Idioventricular Rhythm 

Mystery

100

Healthy in young and athletic hearts, can be associated with HF

S3 

200

Standing/Vasalva ___ venous return to the heart, ____ all murmurs except HOCM and MVP. 

DECREASES 

DECREASES 

HOCM and MVP - get louder 

300

_____ increases venous return to heart, _____ all murmurs except HOCM and MVP. 

Squatting/leg raises 

increases 

400

Loud, associated with a thrill.

What grade is this? 

4/6

500

Decreases AS murmur and increases AR and MR murmur 

Decreases HOCM and MVP

hand gripping/phenylephrine 

(increased total peripheral resistance) 

Miscellaneous

100

3 pan systolic murmurs mentioned in Pearls ppt

1. Ventral septal defect 

2. Mitral regurgitations 

3. Tricuspid regurgitation 

( we need 3 PANS To Make reg. Vanilla)

200

Continuous machinery murmurs (2)

1. Patent ductus arteriosus 

2. AV fistula 

(Machinery - Pt at work DUCTs throws FIST)

300

Inhalation increases __ side murmurs 

Expiration increases __ side murmurs 

RIGHT

Left - (Ex in expiration = exit = they LEFT)

400

Atrial kick against a stiff wall, hypertrophy or scar. 

S4 

500

Coarctation murmur best heard at

UNDER LEFT CLAVICLE where you would normally listen to patent ductus arteriosus