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Myla Shared "Murmurs" - 15 Picmonics

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Murmurs

Aortic Stenosis
Characteristics
Age-related Calcifications
Bicuspid Aortic Valve
Crescendo-decrescendo Murmur
Systolic Murmur
Ejection Murmur
Ejection Click
Radiates to Carotids and Apex
Pulsus Parvus et Tardus
Syncope
Helmet Cells
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2 mins
Aortic Regurgitation
Auscultation
Diastolic Murmur
Immediate High-pitched
Blowing Murmur
Clinical Findings
Wide Pulse Pressure
Water Hammer Pulse
Head Bobbing
Pulsating Nail Bed
Considerations
Can Cause Austin Flint Murmur
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1 min
Tricuspid Regurgitation
Holosystolic
Blowing Murmur
Radiates to Right Sternal Border
Enhanced by Inspiration
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1 min
Mitral Stenosis
Characteristics
Murmur Follows Opening Snap
Late Diastolic Murmur
Enhanced by Expiration
Low-Pitched Rumbling
Dilation of Left Atrium (LA)
Recurrent Attacks of Rheumatic Fever
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2 mins
Mitral Regurgitation
Characteristics
Holosystolic
Blowing Murmur
Loudest at Apex
Radiates toward Axilla
Louder by Squatting
Hand Grip
Expiration
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1 min
Right to Left Heart Shunts
The 5 Ts
Truncus Arteriosus
Transposition of the Great Vessels
Tricuspid Atresia
Tetralogy of Fallot
Total Anomalous Pulmonary Venous Return (TAPVR)
Associations
Cyanosis at Birth
May Require PDA
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1 min
Left-to-Right Heart Shunts
The 3 Ds
Ventricular Septal Defect (VSD)
Atrial Septal Defect (ASD)
PDA
Associations
Later Cyanosis
Clubbing
Eisenmenger's Syndrome
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2 mins
Atrial Septal Defect (ASD)
Pathophysiology
Hole in Septum between the Atria
Symptoms
Often Asymptomatic
Wide and Fixed Split S2
Cyanosis and Dyspnea
Easily Fatigued
Diagnosis
Chest X-ray shows Increased Pulmonary Vascular Markings
Echocardiogram
Treatment
Surgery if CHF as Child
Antibiotic Prophylaxis
Most Close Spontaneously
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2 mins
Ventricular Septal Defect (VSD)
Pathophysiology
Opening at Intraventricular Septum
Most Common Congenital Heart lesion
Symptoms
High-pitched Holosystolic Murmer (over left sternal border)
Dyspnea and Respiratory Distress
Loud Pulmonic S2
Diagnosis
Echocardiogram
Treatment
Small VSDs Close Spontaneously
Large VSDs Require Surgery
Complications
Endocarditis
Eisenmenger's Syndrome
CHF
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2 mins
Patent Ductus Arteriosus
Continuous
Machine like murmur
Often Due to Congenital Rubella
Prematurity
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1 min
Persistent Truncus Arteriosus
Common Arterial Trunk
Single Trunk Emerges from Both Ventricles
Symptoms
Cyanosis
Pulmonary Congestion
Heart Failure
Single S2 Sound
Diagnosis
Echocardiogram
Chest X-ray
Treatment
Early Surgical Correction
Avoids Pulmonary Hypertension
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2 mins
Tetralogy of Fallot (TOF)
Features
Blue Baby Syndrome
Mechanism
PROVe Acronym
Pulmonary Infundibular Stenosis
Right Ventricular Hypertrophy
Overriding Aorta
Ventricular Septal Defect (VSD)
Diagnosis and Treatment
Boot-Shaped Heart
Squatting for Tet Spells
Surgery
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2 mins
Total Anomalous Pulmonary Venous Return (TAPVR)
Pathophysiology
Pulmonary Veins Do Not Connect to Left Atrium
Oxygenated Blood Return to Right Atrium
Incompatible with Life without a Shunt
With Obstruction
Vessel Enters at an Acute Angle
Severe Cyanosis
Pulmonary Edema
Without Obstruction
Delayed Manifestation (1 or 2 years)
Right Heart Failure
Chest X-ray Shows "Snowman"
Diagnosis
Echocardiogram
Treatment
Surgical Correction
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3 mins
Transposition of Great Vessels
Pathophysiology
Pulmonary and Systemic Circulation are in Parallel
Incompatible with Life Without a Shunt
Symptoms
Severe Cyanosis at Birth
Single S2 sound
Diagnosis
Echocardiogram
Chest X-ray shows "Egg-shaped Silhouette"
Treatment
Prostaglandin
Avoid NSAIDs
Surgical Correction
Balloon Atrial Septostomy
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2 mins
Coarctation of The Aorta
Pathophysiology
Constriction of a Portion of Aorta
Turner Syndrome
Symptoms
Asymptomatic Hypertension
BP Higher in Upper Extremities, Right Arm
CHF
Diagnosis
Echocardiogram
Cardiac Catheterization
3 Sign on Chest X-Ray
Rib Notching
Treatment
Surgical Correction
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2 mins

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