Exam (elaborations)
Heart Murmurs - Identifying the Murmur (1
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Heart Murmurs - Identifying the Murmur (1
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Heart Murmurs - Identifying the MurmurAtrial Septal Defect - CORRECT ANSWER-Possible split S1, fixed widely split S2
with snap heard best at the fourth left intercostal space
Patent Ductus Arteriosus - CORRECT ANSWER-Palpable thrill and machine-like
murmur along the left sternal border. Paradoxical S2.
Mitral Regurgitation - CORRECT ANSWER-Holosystolic murmur heard best in the
fifth intercostal space (apex)
Mitral Valve Prolapse - CORRECT ANSWER-Mid-to-late systolic click with late
systolic murmur heard best in the fifth intercostal space (apex)
Mitral Stenosis - CORRECT ANSWER-Opening snap with diastole, then a
decrescendo w/ an S1 sound that is louder than S2, heard best in the fifth intercostal
space (apex) using the bell.
Aortic Stenosis - CORRECT ANSWER-Paradoxically split S2 with harsh
crescendo/decrescendo murmur heard at the right second intercostal space.
Aortic Regurgitation - CORRECT ANSWER-Diastolic blowing decrescendo murmur
heard at the left third intercostal space.
Tricuspid Regurgitation - CORRECT ANSWER-Blowing, holosystolic murmur heard
at the left lower sternal border than may mask mitral stenosis.
Pulmonic Regurgitation - CORRECT ANSWER-Early diastolic murmur with potential
S3 sound in more severe cases or no murmur in mild cases. Present murmurs are
auscultated in the left sternal border at the second and third intercostal.
Pulmonic Stenosis - CORRECT ANSWER-Systolic ejection murmur with pulmonary
ejection "click."
Aortic Prosthesis - CORRECT ANSWER-Early systolic click with variable timing and
intensity.
Mitral Prosthesis - CORRECT ANSWER-Early diastolic click with variable timing and
intensity.
S3 Sound - CORRECT ANSWER-Ventricular gallop; sound of filling in a resistant
ventricle during the early rapid filling phase heard at apex.
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