Harsh systolic ejection crescendo-decrescendo murmur at the right upper sternal border (aortic
place) with radiation to the neck and apex heard pleasant through leaning ahead with expiration
Aortic stenosis
harsh, loud, medium pitched systolic murmur heard first-rate on the second /3rd left intercostal
area (pulmonic area) which could lower with concept
Pulmonic stenosis
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holosystolic high-pitched blowing murmur at apex (mitral area) that radiates to axilla with a split
S2
Mitral regurgitation
high pitched holosystolic murmur at LLSB (tricuspid area) radiates to the sternum and increases
with concept
Tricuspid stenosis
midsystolic ejection click on heard best at the apex (mitral region)
MVP
, gentle early diastolic blowing murmur along left sternal border with affected person sitting
leaning ahead after exhaling
Aortic regurgitation
high pitched early diastolic decrescendo murmur at the LUSB (pulmonic location) that increases
with proposal
Pulmonic regurgitation
diastolic low pitched decrescendo rumbling murmur with commencing snap heard satisfactory at
the apex (mitral location) with patient in lateral decubitus position
Mitral stenosis
diastolic rumbling murmur on the LLSB (tricuspid region) with an opening snap
Tricuspid stenosis
a 30-year-vintage female presents with 2 weeks of arthralgias, migrating from distal to proximal
joints. It started with expanded warm temperature and erythema in her right ankle and left knee.
She has a low-grade fever and reports a history of sore throat and swollen glands approximately
1 month ago. On physical examination she has pink skin lesions on the trunk and proximal
extremities, and also small, non-gentle lumps positioned over the joints. Antistreptolysin O titer
is fine.
What is suspected?
Rheumatic fever --> JONES CRITERIA
How is rheumatic fever handled?
Penicillin G, aspirin (fever manipulate), corticosteroids
How is endocarditis handled?
IV ABX
Prophylaxis --> Vanco (MCC is staph)
S. Aureus --> nafcillin or cefazolin
2 units of blood cultures each 24-48h till infection clears from bloodstream
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