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Cardiology: Murmurs ABIM questions with 100% correct answers graded A+
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Cardiology: Murmurs ABIM questions with 100% correct answers graded A+
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Cardiology: Murmurs ABIMWhen is Transthoracic echocardiography Required? - correct answer ✔✔systolic murmurs grade 3/6 or
higher, late systolic murmurs, holosystolic murmurs, diastolic murmurs, continuous murmurs, murmurs
w. ejection clicks, murmurs that radiate to neck or back.
What are Systolic Heart Murmurs? - correct answer ✔✔Aortic Stenosis (crescendo-decrescendo),
Mitral/Tricuspid (holosystolic, high pitched), Ventral septal defect (holosystolic, harsh), Mitral valve
prolapse (late crescendo, mid-systolic click)
What is Aortic Stenosis? - correct answer ✔✔crescendo-decrescendo systolic ejection murmur, radiates
to carotids
What is Low Flow Aortic Stenosis? - correct answer ✔✔exertion dyspnea, carotid upstroke low volume;
dx-dobutamine ECHO
What is Mitral Regurgitation? - correct answer ✔✔blowing holosystolic murmur radiates to axilla; dx-
TTE→TEE for acute
What is Tricuspid Regurgitation? - correct answer ✔✔blowing holosystolic murmur at left 2nd/3rd ICS,
↑with inspiration; pulsatile liver/cor pulmonale, drug users, carcinoid syndrome
What is Ventricular Septal Defect? - correct answer ✔✔harsh holosystolic murmur at LLSB w. thrill; dx-
ECHO
What is Mitral Valve Prolapse? - correct answer ✔✔late systolic crescendo murmur w. midsystolic click
What are Diastolic Heart Murmurs? - correct answer ✔✔Aortic regurgitation (high pitched blowing, wide
pulse pressure), Pulmonary regurgitation (TOF repair), Mitral stenosis (opening snap)
, What is Aortic regurgitation? - correct answer ✔✔high pitched blowing early diastolic decrescendo; dx-
TTE;
What is Aortic regurgitation? - correct answer ✔✔
What is Pulmonary regurgitation? - correct answer ✔✔diastolic murmur increases in intensity w/
inspiration @ LLSB, single S2, TOF repair,
What is Mitral Stenosis? - correct answer ✔✔diastolic rumble, opening snap, dyspnea (pulm
congestion); worse w. exertion; dx- stress ECHO for discrepancy btw clinical & ECHO; (tx-anticoag, IRN
2.0-3.0 if Afib/left atrial thrombus/systemic embolization; pregnancy-IV B-blocker)
What are Continuous Murmurs? - correct answer ✔✔Patent ductus arteriosus
What is Patent Ductus Arteriosus? - correct answer ✔✔continuous machinery murmur, IE, pulm HTN; dx-
TTE; (tx-closure, symptomatic/L heart enlargement/L→R shunting
What are Click Murmurs? - correct answer ✔✔mitral valve prolapse (late systolic crescendo, midsystolic
click), pulmonary valve stenosis (midsystolic ejection murmur, ASD), bicuspid aortic valve (ejection click,
followed by midsystolic murmur)
What is Pulmonary valve stenosis? - correct answer ✔✔RVH, ejection click, (tx-balloon valvuloplasty,
peak Doppler gradient > 50 mm Hg, or mean PV gradient >30 mm Hg)
What is Bicuspid Aortic Valve? - correct answer ✔✔systolic ejection click
What is Atrial Septal Defect? - correct answer ✔✔wide- fixed split of second heart sound, right axis
deviation, incomplete RBBB, right ventricular heave, pulmonic valve (midsystolic ejection), tricuspid valve
(mid diastolic); dx-TTE; (tx-closure if dyspnea, right sided chamber enlargement, pacemaker placement;
monitor w/ECHO, asymptomatic, small ASD no right heart enlargemetn)
What is Atrial Septal Defect: Ostium Primum? - correct answer ✔✔fixed splitting of S2, MR, left-axis
deviation
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