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Murmur Guide

Murmur Guide

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Published by Stephanie Hill
Heart Murmurs USMLE
Heart Murmurs USMLE

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Categories:Types, School Work
Published by: Stephanie Hill on Aug 24, 2014
Copyright:Traditional Copyright: All rights reserved

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08/24/2014

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You most know the locations of the murmurs
 
 
Upper Right Sternal Border = Aortic.
 
Upper Left Sternal Border = Pulmonic.
 
Lower Left Sternal Border = Tricupid.
 
Left 5th intercostal space at midclavicular line = Mitral. So if they say the point the murmur is
 heard loudes
t is at the
midclavicular line
, you KNOW its a mitral murmur!!
Determine if its a systolic or diastolic murmur
 
MRS MSD hARD ASS
 MR mitral regurgitation Systolic MS mitral stenosis Diastolic AR aortic regurgitation Diastolic AS aortic stenosis Systole If the murmur is at the
 upper right sternal border 
, it MUST be an
aortic murmur
. Is it systolic? Stenosis Diastolic? Regurg.
RiLe
 
 Right Side murmurs increased with Inspiration
 Tricuspid Pulmonary
 Right-sided heart sounds
 increase on inspiration because during inspiration the blood is increased to the heart (less intrathoracic pressure), thus there is more blood flow through the right side of the heart--> louder heart sounds
 Left Side murmurs increased with Expiration
 Mitral Aortic
 Left-sided heart 
 sounds increase on expiration because during expiration, you are pushing your blood out into the systemic circulation (more intrathoracic pressure), thus there is more blood flow through the left side of the heart--> louder heart sounds There are a couple places they can trick you.
Mitral Regurg/Prolapse.
 You need to be able to pick up a click if there is one. Is there a click? Prolapse.  If there's a click and its a diastolic murmur, it CAN'T be prolapse, it has to be Stenosis They're also big on classic associations. If its a
mitral prolapse
, its almost always in a Marfan's or adult polycystic kidney disease patient.

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