Heart Murmurs with Real Examples

An brand new overview of all the important heart murmurs, packed full of real life examples and illustrations

 

Lecture by

Video Duration: 28 minutes

  • Aortic Stenosis
    Created by Alison Thornton
    General
    Epidemiology

    Narrowing of the aortic valve, between the left ventricle and aorta, leading to valve not opening fully

    Most common murmur, occurs in 10% of over 80's!

    Pathology

    The stenosis restricts the blood flow from the left ventricle to the aorta leading to an increased pressure in the left atrium

    Top three causes

    1. Calcium deposition

    2. Congenital - Bicuspid aortic valve

    3. Old age

    Clinical Features
    Symptoms

    Triad: Dyspnoea, Syncope, Palpitations

    Others: chest pain, tired, hypotension, impaired exercise tolerance, sudden death

    Signs

    Slow rising pulse

    Narrow pulse pressure

    Apex palpable thrill

    Ejection Systolic murmur

    Investigations
    Cultures

    None

    Bloods

    None

    Imaging

    CXR: cardiac enlargement, calcification of aorta - however often normal

    Scopic/Biopsy

    None

    Functional

    Echo - Diagnostic

    ECG - may show Left ventricular hypertrophy

    Treatment
    Conservative

    Avoid heavy exertion

    If asymptomatic: follow up with Echo

    Medical

    If symptomatic but unsuitable for surgery medical treatment can be used:

    - Digoxin, Diuretics, ACEi to treat the symptoms

    Surgical

    Aortic valve replacement

    Balloon valvuloplasty