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Cardio Exam

The Patient
The Hands
The Arms
The Head
The Neck
The Chest - Inspection
The Chest - Palpation
The Chest - Auscultation
The Back
The Abdomen
The Legs

Listening for Murmurs

    • How to Assess
    • Auscultate while palpating the pulse (preferably the carotid). Identify whether the murmur is systolic (between S1 and S2), diastolic (between S2 and S1 of the next cardiac cycle) or continuous.
    • Interpretation
    • 1/6: The faintest murmur, audible with the most careful auscultation.
    • 2/6: A faint murmur that is easily heard.
    • 3/6: Prominent, louder than the heart sounds.
    • 4/6: A loud murmur, accompanied by a thrill.
    • 5/6: A very loud murmur that can be heard with the edge of the stethoscope in contact with the skin.
    • 6/6: A murmur audible with the stethoscope off the chest.

Systolic Murmur

    • Causes of Systolic Murmur
    • Aortic stenosis
    • Mitral regurgitation
    • Tricuspid regurgitation
    • Ventricular septal defect
    • Hypertrophic obstructive cardiomyopathy
    • Pulmonary stenosis
  • Soft systolic murmur - likely innocent murmur due to physiological bloodflow
    • Systolic Murmur
  • Early systolic murmur - ventricular septal defect, mitral regurgitation, tricuspid regurgitation
    • Systolic Murmur
  • Ejection (Mid)Systolic Murmur - aortic or pulmonary stenosis
    • Systolic Murmur
  • Late systolic murmur - mitral valve prolapse
    • Systolic Murmur
  • Pansystolic murmur - tricuspid or mitral regurgitation
    • Systolic Murmur

Diastolic Murmur

    • Causes of Diastolic Murmur
    • Aortic regurgitation
    • Mitral stenosis
    • Pulmonary regurgitation
    • Tricuspid stenosis
  • Early diastolic - aortic or pulmonary regurgitation
    • Diastolic Murmur
  • Mid-diastolic - mitral stenosis
    • Diastolic Murmur
  • Late diastolic / presystolic - tricuspid stenosis
    • Diastolic Murmur

Continuous Murmur

    • Causes of Continuous Murmur
    • Patent ductus arteriosus
    • AV fistula
    • Ruptured sinus of Valsalva aneurysm
    • Aortopulmonary window
    • Continuous Murmur

Associated Diseases

Valvular Disease
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