Heart murmur resident survival guide

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

This section provides a short and straight to the point overview of the disease or symptom. The first sentence of the overview must contain the name of the disease.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

systolic murmur
- Ejection murmurs
  - Functional
    - Still's murmur and its adult variant
    - Flow murmur emanating from the root of the pulmonary artery
    - Murmur associated with high cardiac output states
    - Flow murmurs associated with aortic or pulmonary valvular insufficiency
  - Organic
    - Valvular aortic stenosis
    - Aortic sclerosis
    - Discrete subvalvular aortic stenosis (web or tunnel)
    - Supravalvular aortic stenosis
    - Hypertrophic obstructive cardiomyopathy
    - Pulmonary valvular stenosis
    - Pulmonary infundibular stenosis
    - Atrial septal defect
    - Tetralogy of Fallot
- Regurgitant murmurs
  - Functional: none
  - Organic:
    - Mitral regurgitation:
      - Rheumatic
      - Papillary muscle dysfunction
      - Mitral valve prolapse
      - Acute
    - Tricuspid regurgitation:
      - Chronic
      - Acute
    - Ventricular septal defect
      - Roger's type (small and large)
        Without pulmonary hypertension
        
        With pulmonary hypertension
      - Slitlike
  - Extracardiac sounds simulating systolic heart murmurs
    - Subclavian (supraclavicular/brachiocephalic) murmur
    - Internal mammary soufflé
    - Carotid artery bruits
    - Coarctation of the aorta
    - Murmurs emanating from a dilated aortic or pulmonary artery root
    - Patent ductus arteriosus with pulmonary hypertension

- Holosystolic (pansystolic) murmurs:
  - chronic MR.
  - chronic TR.
  - VSD
  - PDA with pulmonary hypertension
- Midsystolic (systolic ejection) murmurs
  - Innocent murmur (still's murmur)
  - AS
  - PS
  - HOCM
  - Functional:
    - ASD
    - VSD
    - Straight back syndrome
    - Aortic root dilation
    - Pulmonary artery dilation
    - pulmonary hypertension
    - Hyper-kinetic status:
      - pregnancy
      - Anemia
      - hyperthyroidism
      - exercise
      - A-V fistula
- Early systolic murmurs
  - Acute MR
  - Acute TR
  - Small VSD
- Mid to late systolic murmurs
diastolic murmur
- Aortic regurgitation
- Pulmonary valve regurgitation
- Mitral rumble
  - - Obstruction to flow
      - Mitral stenosis (rheumatic, congenital)
      - Left atrial myxoma
      - Cor triatriatum
      - Localized pericardial constriction
    - Increased flow
      - Mitral regurgitation
      - Ventricular septal defect
      - Patent ductus arteriousus
      - Complete heart block

- - 1. Tricuspid rumble
      1. Obstruction to flow
        Tricuspid stenosis (rheumatic, Ebstein's anomoly, carinoid)
        
        Right atrial myxoma
        
        Localized pericardial constriction
      2. Increased flow
        Atrial septal defect
        
        Tricuspid regurgitation
continuous murmur

Diagnosis

Shown below is an algorithm summarizing the diagnosis of [[disease name]] according the the [...] guidelines.

Treatment

Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.

Do's

The content in this section is in bullet points.

Don'ts

The content in this section is in bullet points.

References

Template:WikiDoc Sources