First Aid - Cardiovascular - Heart Sounds

Holosystolic, high pitched "blowing murmur"

Mitral / tricuspid regurgitation
**mitral - apex, radiates to axilla
**tricuspid - tricuspid area, radiates to rt sternal border

ejection click followed by crescendo-decrescendo systolic

Aortic stenosis
-click - abrupt halting of valve leaflets
-LV pressure >> aortic during systole
-radiates to carotids

Holosystolic, harsh-sounding murmur; tricuspid area

VSD

Late systolic crescendo murmur, midsystolic click, loudest at S2

Mitral proplapse
-Most frequent valvular lesion
-usually benign
-mid click due to sudden tensing of chordae tedinaea
-can predispose to infective endocarditis

Possible causes:
-myxomatous degeneration
-rheumatic fever
-chordae rupture

Immediate, high-pitched "blowing" diastolic murmur

Aortic regurgitation (AR)
-wide pulse pressure when chronic
-bounding pulses / head bobbing

Possible causes:
-often due to aortic root dilation
-bicuspid aortic valve
-rheumatic fever

delayed late diastolic rumbling murmur

Mitral stenosis
-follows opening snap (abrupt half in leaflet motion, after rapid opening, due to fusion at leaftips)
-LA >> LV during diastale

Possible causes:
-2ndary to rheumatic fever
-chronic MS --> LA dilation

continuous machine-like murmur

PDA
-loudest at S2
-often due to congenital rubella
-prematurity