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Medicine

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Cardiology

Question
11 out of 13
 

Continuous murmur is found in (select three options) (PGI Nov 2009, June 2011)



A AS combined with AR

B Systemic A V fistula

C PDA with reversal of shunt

D Aortopulmonary window

E Rupture of sinus Valsalva

Ans. B

Systemic A V fistula, D . Aortopulmonary window, E . Rupture of sinus Valsalva

1. Early systolic =

a. VSD with PAH,

b. Very small VSD

c. An early systolic murmur is a feature of tricuspid regurgitation occurring in the absence of pulmonary hypertension, a lesion that is common in narcotics abusers with infective endocarditis. (Ref. Hari – 18th ed., 1387)

2. Midsystolic murmurs – (Ejection Systolic murmurs) – a. AS b. PS

3. Late systolic murmurs – MVPQ , Papillary muscle dysfunction.Q

4. Pan systolic murmurs:

a. MR Q,

b. TR Q,

c. VSD Q

5. Early diastolic murmurs:

a. AR,

b. PR

6. Mid diastolic murmurs :

a. MSQ,

b. TSQ,

c. Carey-Coombs murmur Q,

d. Atrial myxoma Q,

e. Austin Flint,

7. Graham Steel (Extra Edge: Please note that all named murmur are diastolic !!!).

8. Carry Coombs murmur = It is a low pitch, mid or delayed diastolic murmur produce due to increase diastolic flow secondary to MR in acute rheumatic carditis.

9. Late diastolic murmur = atrial myxoma (In this it can also be mid diastolic murmur)

10. Continuous murmurs-

Causes

1. PDAQ

2. Coronary AV fistulaQ

3. Ruptured sinus of ValsalvaQ

4. ASD with MS (Lutembacher syndrome) Q

5. Co-arctation

6. Pulmonary embolism

7. Systemic AV fistula

8. Pulmonary AV fistula

9. Changing murmurs - changes in character from moment to moment.

Causes- Infective endocarditis, Atrial thrombus, Atrial myxoma

10. Mammary souffle = Innocent continuous murmur heard over breast in pregnancy.

11. Venous hum = heard in pregnancy, at right supra clavicular area.

Cardiology Flashcard List

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