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    Heart Murmurs: Kiran Dhaliwal

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    tigermonkey
    This document provides an overview of heart murmurs, including normal heart sounds, classification of murmurs, and the main types of valvular heart disease and their associated murmurs. It discusses aortic stenosis, including causes like senile degeneration, signs like dizziness and chest pain, and physical exam findings like an ejection systolic murmur loudest in the aortic area. It also discusses aortic regurgitation, mitral stenosis, and mitral regurgitation, covering causes, signs and symptoms, and physical exam findings for each. The document concludes with instructions on examining a patient with a murmur and sample exam questions.

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    Heart Murmurs: Kiran Dhaliwal

    Uploaded by

    tigermonkey
    39 views42 pages
    This document provides an overview of heart murmurs, including normal heart sounds, classification of murmurs, and the main types of valvular heart disease and their associated murmurs. It discusses aortic stenosis, including causes like senile degeneration, signs like dizziness and chest pain, and physical exam findings like an ejection systolic murmur loudest in the aortic area. It also discusses aortic regurgitation, mitral stenosis, and mitral regurgitation, covering causes, signs and symptoms, and physical exam findings for each. The document concludes with instructions on examining a patient with a murmur and sample exam questions.

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    GP Teaching

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    This document provides an overview of heart murmurs, including normal heart sounds, classification of murmurs, and the main types of valvular heart disease and their associated murmurs. It discusses aortic stenosis, including causes like senile degeneration, signs like dizziness and chest pain, and physical exam findings like an ejection systolic murmur loudest in the aortic area. It also discusses aortic regurgitation, mitral stenosis, and mitral regurgitation, covering causes, signs and symptoms, and physical exam findings for each. The document concludes with instructions on examining a patient with a murmur and sample exam questions.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    39 views42 pages

    Heart Murmurs: Kiran Dhaliwal

    Uploaded by

    tigermonkey
    This document provides an overview of heart murmurs, including normal heart sounds, classification of murmurs, and the main types of valvular heart disease and their associated murmurs. It discusses aortic stenosis, including causes like senile degeneration, signs like dizziness and chest pain, and physical exam findings like an ejection systolic murmur loudest in the aortic area. It also discusses aortic regurgitation, mitral stenosis, and mitral regurgitation, covering causes, signs and symptoms, and physical exam findings for each. The document concludes with instructions on examining a patient with a murmur and sample exam questions.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 42

    Heart murmurs

    Kiran Dhaliwal

    Contents
    Introduction to heart murmurs Normal heart sounds Classification of murmurs Commonest types of valvular disease and associated heart murmurs
    Causes Signs and symptoms Investigations and treatment

    How to examine a patient with a murmur Quiz

    What is murmur?
    An abnormal sound heard during the cardiac cycle. (Mayo Clinic) Caused by turbulence of blood flow which occurs when the velocity of the blood is disproportionate to the size of the orifice it is moving through (Cardiology Crash Course)

    Normal heart sound

    Classification of murmurs

    Classification of murmurs

    Classicisation of murmurs
    Systolic
    Ejection systolic Pansystolic

    Diastolic
    Early distolic Mid-distolic

    Continuous

    Grading heart murmurs

    Ejection systolic murmurs


    Cresendo-decresendo systolic murmur

    Heart valve pathology


    Mitral valve disease
    Mitral stenosis Mitral regurgitation

    Aortic valve disease


    Aortic stenosis Aortic reurgitation

    Causes Signs and symptoms Examination


    Pulse Blood pressure Palpation (apex beat) Ausultation

    Aortic stenosis
    What type of murmur does it produce? What would it look like?

    Causes of aortic stenosis


    Senile degeneration of aortic valve Rheumatic aortic stenosis Calcification of bicuspid valve Congenital

    Signs and symptoms of aortic stenosis


    Symptoms Mild or moderate aortic stenosis is usually asymptomatic Sudden death Episodes of acute pulmonary oedema

    Triad of symptoms Dizziness SOB Chest pain

    Examination
    Pulse
    Reduced volume Slow rising pulse

    Blood pressure
    Narrow pulse pressure

    Palpitation
    Heaving non-displaced apex beat

    Ausculatation
    Ejection systolic murmur Loudest in aortic region Radiates into the carotids

    Aortic regurgitation
    Clinical features Collapsing pulse Wide pulse pressure

    Austin flint murmur Diastolic murmur High pitched Best heard with

    Causes of aortic regurgitation

    Signs and symptoms of aortic stenosis


    Fatigue Dyspnoea

    Examination
    Pulse
    Large volume Collapsing pulse

    Blood pressure
    Wide pulse pressure

    Palpation
    Displaced, heaving apex beat

    Auscultation
    Early diastolic murmur Blowing High pitched (listen with diaphragm) Loudest in left sternal edge of 4th intercostal space)

    Mitral stenosis
    Malar flush Atrial fibrilation (if severe) Tapping displaced apex beat

    Causes of mitral stenosis

    Mitral regurgitation

    Causes of mitral regurgitation


    Rheumatic fever (50%) SLE Ischemic heart disease Drugs
    Appetite suppresants
    Fenfluramide

    dopamine agonists
    Cabergoline

    Other types of murmurs


    Info included in handout

    Examination
    Inspection
    Scars Heave Hands
    Peripheral stigmata of infective endocarditis

    Cardiovasular system examination


    Pulse Blood pressure JVP

    Ausulatation

    Auscultation

    Examination
    Palpation
    Thrills

    Examination of a patient
    Does the patient have any signs of valve disease Does the patient have a murmur
    Describe murmur Timing Radiation

    Review of patient

    10 minutes

    1. What murmur is this?


    Audio clip

    2.
    A patient reports SOB on exertion, which gradually becomes more severe PMH: Rheumatic fever as a child On examination they have AF

    3. What murmur is this?


    Audio clip

    4.
    On examination a patient has a low volume pulse with a small pulse pressure A systolic thrill is palpable at the apex over the aortic area

    5. What murmur is this?


    Audio clip

    6. What murmur is this?


    Audio clip

    Summary

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