Heart Sounds & Murmurs Flashcards¶
Anki-compatible flashcards for Heart Sounds & Murmurs board review.
Q: What does a fixed split S2 indicate? A: ASD - S2 splitting does not vary with respiration due to constant LA→RA shunting Tags: heart-sounds, s2, asd, high-yield
Q: What does a single S2 suggest? A: Severe AS, pulmonary atresia, truncus arteriosus, or TGA - only one semilunar valve producing sound Tags: heart-sounds, s2, high-yield
Q: What does a loud P2 indicate? A: Pulmonary hypertension - increased pulmonary artery pressure causes louder pulmonic component Tags: heart-sounds, s2, pulmonary-hypertension
Q: Is S3 normal or abnormal in children? A: S3 is NORMAL in children and young adults; pathologic only if associated with heart failure or volume overload Tags: heart-sounds, s3, high-yield
Q: Is S4 normal or abnormal in children? A: S4 is ALWAYS ABNORMAL in children - indicates decreased ventricular compliance (HCM, HTN) Tags: heart-sounds, s4, high-yield
Q: What is the "Ken-TUC-ky" cadence? A: S3 gallop - early diastolic extra sound after S2 Tags: heart-sounds, s3
Q: What is the "TEN-nes-see" cadence? A: S4 gallop - late diastolic extra sound before S1 Tags: heart-sounds, s4
Q: What does an early systolic ejection click suggest? A: Valve abnormality - bicuspid aortic valve or pulmonary stenosis Tags: heart-sounds, click, high-yield
Q: What does a mid-systolic click suggest? A: Mitral valve prolapse Tags: heart-sounds, click
Q: What are the 6 grades of murmur (Levine scale)? A: I=barely audible, II=soft but heard, III=moderately loud no thrill, IV=loud with thrill, V=very loud barely touching chest, VI=audible off chest Tags: murmur, grading, high-yield
Q: At what grade does a murmur have a thrill? A: Grade IV and above - palpable vibration indicates significant murmur Tags: murmur, grading, high-yield
Q: What type of murmur is crescendo-decrescendo (diamond-shaped)? A: Systolic ejection murmur - seen with AS, PS, and flow murmurs Tags: murmur, timing
Q: What type of murmur is holosystolic (plateau-shaped)? A: Regurgitant murmur - VSD, MR, TR (blood flowing through abnormal orifice throughout systole) Tags: murmur, timing, high-yield
Q: Are diastolic murmurs ever innocent? A: NO - diastolic murmurs are ALWAYS pathologic and require echocardiography Tags: murmur, diastolic, high-yield
Q: What is a continuous murmur that persists through S2? A: PDA (machinery murmur), venous hum (innocent), AV fistula Tags: murmur, continuous
Q: Where is the aortic area for auscultation? A: Right upper sternal border (RUSB) - 2nd right intercostal space Tags: murmur, location
Q: Where is the pulmonic area for auscultation? A: Left upper sternal border (LUSB) - 2nd left intercostal space Tags: murmur, location
Q: Where do you best hear VSD? A: Left lower sternal border (LLSB) - 4th left intercostal space Tags: murmur, location, vsd
Q: A murmur that radiates to the carotids suggests what? A: Aortic stenosis - flow directed into great vessels Tags: murmur, radiation
Q: A murmur that radiates to the axilla suggests what? A: Mitral regurgitation - jet directed posterolaterally Tags: murmur, radiation
Q: What are the 6 S's of innocent murmurs? A: Soft, Short (systolic), Single S2, Symptom-free, Size normal, Sound musical/vibratory Tags: innocent-murmur, high-yield
Q: Smaller VSD = louder or softer murmur? A: LOUDER - more turbulence through restrictive defect; large VSD may be soft Tags: murmur, vsd, high-yield
Q: What maneuver makes HCM murmur louder? A: Valsalva or standing - decreased venous return worsens obstruction Tags: murmur, hcm, high-yield
Q: What is the classic murmur of Still's murmur? A: Musical/vibratory murmur at LLSB, Grade I-II, changes with position, most common ages 3-7 Tags: innocent-murmur, stills
Q: What auscultatory findings require echocardiography? A: Diastolic murmur, Grade ≥III, abnormal S2 splitting, associated symptoms, thrill Tags: murmur, workup, high-yield