What are the two types of systolic murmur and two types of diastolic murmur?
Pansystolic
Ejection systolic
Early diastolic
Mid diastolic
What is a pan systolic murmur?
Starts at S1, extends up to S2 Usually due to regurgitation
Sound looks like block
What is an ejection systolic murmur?
Crescendo-decrescendo murmur Starts at S1 ends at S2
What is an early diastolic murmur?
Decrescendo Starts at S2 ends at S1
What is a mid diastolic murmur?
Starts at S2 ends at S1 Looks wavy
What is the difference between left-sided and right-sided murmurs?
Right sided murmurs are louder with inspiration
Which murmurs are always pathological?
Diastolic murmurs
What is a valve stenosis?
valves which don’t open properly
What is valve regurgitation?
Valves which do not close properly
What is mixed valve disease
Valves which don’t open or close properly
What are some causes of aortic stenosis? (SYSTOLIC)
- Degenerative - Congenital - Rheumatic
What are the symptoms of aortic stenosis?
- Breathlessness - Chest pain - Dizziness/syncope
What murmur are these signs indicating?
- Low volume pulse - Forceful displaced apex - Ejection systolic murmur that can radiate to the carotids
What is the treatment for aortic stenosis?
- Conventional valve replacement - Trans catheter aortic valve replacement (TAVI) - Balloon Aortic Valvotomy (BAV)
What are the causes of mitral regurgitation? (SYSTOLIC)
- Mitral valve prolapse - Rheumatic (damaged valves) - Endocarditis - Chordae/papillary muscle rupture - Myxomatous (floppiness)
What are the symptoms of mitral regurgitation?
- Breathlessness - Peripheral oedema - Fatigue
What are signs of mitral regurgitation?
- Displaced apex - Pansystolic murmur
What is the treatment for mitral regurgitation?
- Diuretics - ACE inhibitors - Repair - Replace - Clips in infancy
What are the main causes of mitral stenosis? (DIASTOLIC)
- Rheumatic heart disease (valve damage) most common - Congenital (rare)
What are the symptoms for mitral stenosis?
- Breathlessness - Fatigue - Palpitations (AF)
What are the signs of mitral stenosis?
- Malar flush - Tapping apex beat (palpable first heart sound) - Mid diastolic rumbling (diastolic murmur localised to apex)
What is the treatment for mitral stenosis?
- Diuretics - Treat atrial fibrillation - Valve replacement surgery - Balloon valvuloplasty
What are the causes of aortic regurgitation? (diastolic)
- Endocarditis - Connective tissue diseases - Rheumatic - Marfans (disorder of connective tissue) - Aortic dissection
What is the main symptom for aortic regurgitation?
Breathlessness
What are the signs for aortic regurgitation?
- Collapsing pulse - Wide pulse pressure - Displaced apex - Early diastolic murmur on left sternal edge
What is the usual treatment for aortic regurgitation?
- ACE inhibitors - LV dilation - Valve replacement