Cadiac Sounds And Ddx

Front 1

What makes the first heart sounds?
If it is loud?
If it is soft?

Back 1

mitral and tricuspid valves
mitrial valve stenosis
mitral valve regurigitation

Front 2

What makes the second heart sounds?
If it is loud?
If it is soft?

Back 2

Closing of A2 and P2
If A2 aortic HTN, if P2 pulmononary HTN
If soft aortic regurgitation, and calcification of aortic valve

Front 3

What is the DDX when pt has splitting of S2?

Back 3

explaination: A2 closes too early or P2 closes too late
1- on inspiration- physiologial; or delayed RV emptying pulmon stenosis RBBB
2- fixed- ASD (atrial septal defect)

Front 4

When do S3 happen?
Where can we hear them?
Why do they occur?

Back 4

1- early to mid-diastole
2- during expiration; @ apex
3- ventricular distention problems

Front 5

What is the DDx of a S3?

Back 5

1- normal finding in children
2- constrictive pericarditis
3- mitral/tricuspid regurgi
4- LVF/ RVF

Front 6

When do we hear S4?
Why do S4s happen?

Back 6

late in diastole
ventricular filling resistance

Front 7

DDx for S4 sounds?

Back 7

1- HTN
2- MI
3- Heart Block
4- aortic stenosis

Front 8

When do we hear the opening snap?
Where do we hear an opening snap?
Why do opening snaps occur?

Back 8

1-high pitched ounds after S2
2- lower left sternal edge
3- stiff mitral valve

Front 9

DDx for opening snap?

Back 9

mitral stenosis

Front 10

When do we hear a systolic click?
Where do we hear a systolic click?
Why does this happen?

Back 10

1- shortly after S1, following a AS or PS mummur
2- in aorotic and pulmonary sites
3- where a stiff valve opens

Front 11

DDx of systolic click?

Back 11

AS

Front 12

Pnemoic for Murmurs:

Back 12

1- PASS
Pulmonary and Aortic Stenosis= Systolic
2- PAID
Pulmonary and Aortic Insufficentcy= Diastole

Front 13

Grading of Murmurs:

Back 13

1cardiologist can hear
2 trainned dr can hear
3 med student can hear
4barely palpable
5 very palpable
6 can hear from the room