Cardiac Murmurs and Heart Sounds

Heart Sounds:

Loud S1 : 1) Tachycardia

2) High output states

3) Mitral stenosis

4) Short PR interval

Soft S1 :

1) Obesity

2) Long PR interval

3) Mitral regurgitation

4) Mitral valve calcification

Widening of S1 : Complete right bundle branch block

Reversed splitting of S1

1)Severe MS

2) Left atrial myxoma

3) Left Bundle Branch Block

Wide Fixed splitting of S2

1) ASD

Reversed Splitting of S2:

1)LBBB

2) Severe aortic outflow obstrucion

3) Large aorta to pulmonary artery shunt

4) Systolic hypertension

5) IHD

6) ICMP with LVF

Heart Murmurs :

Pansystolic murmur

1) MR

2) TR

3) PDA

4) VSD

Midsystolic murmurs :

Often crescendo -decrescendo in shape

1) Functional murmurs

2) AS

3) HOCM

Early Systolic murmur:

1)Large VSD with pulmonary hypertension

2) Small VSD

3) TR

4) Acute MR

Late Systolic murmurs

1) MI leading to papillary muscle dysfunction

2) MVP

Early diastolic murmurs

1) Aortic and pulmonary regurgitation

Murmur of AR increases with handgrip exercise and decreases with amyl nitrate inhalation

Middiastolic murmurs :

1) Mitral stenosis

2) Tricuspid stenosis

3) Acute rheumatic fever ( Carey coomb murmur)

4) Aortic regurgitation ( Austin flint murmur)

Late diastolic murmurs:

Right or left atrial myxoma

Continuous murmurs:

1) PDA

2) Congenital or acquired AV fistula

3) Coronary AV fistula

4) Anomalous origin of coronary from pulmonary artery

5) Communication between sinus of valsalva and right side of heart

6) Coarctation of aorta

Source: www.pgexam.com