Name the Murmur Quiz

Heart Murmur Quiz

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Question 1

When you place your stethoscope on your patient you hear  an early to mid systolic murmur in the pulmonic area with a fixed wide split S2 sound. What is the most likely diagnosis?

A
Pulmonary stenosis
B
Ventricular septal defect
C
Pulmonary valve regurgitation
D
Atrial septal defect
Question 1 Explanation: 
Fixed wide S2 splitting should immediately make you think about atrial septal defects.
Question 2

This is a harsh holosystolic murmur that is found at the apex. The murmur has a medium to high pitch sound. The sound of the murmur does not get louder with inspiration. The sound can radiate to the left axilla and sometimes the left sternal boarder. What is the most likely murmur?

A
Aortic stenosis
B
Mitral valve regurgitation
C
Tricuspid regurgitation
D
Ventricular septal defect
Question 2 Explanation: 
Always pay attention to locations. Both Mitral valve and Tricuspid valve regurgitation are holosystolic murmurs, but the sound being loudest at the apex and radiating to the axilla are great clues for Mitral valve regurgitation.
Question 3

Which murmur is often described as a late systolic crescendo with a mid-systolic click?

A
Mitral valve stenosis
B
Aortic insufficiency
C
Mitral valve prolapse
D
Aortic stenosis
E
Aortic regurgitation
Question 3 Explanation: 
Mitral valve prolapse has a late systolic crescendo with a mid-systolic click. The sound of the mid-systolic click is created by the sudden tightening of the chordae tendineae in the left ventricle.
Question 4

This murmur is heard along the 3rd, 4th, and 5th intercostal spaces on the left side. The sound is holosystolic, harsh, and high  pitched. The sound can radiate widely. It can be loud and may have a thrill. What is the most likely cause of this murmur sound?

A
Mitral valve prolapse
B
Ventricular septal defect
C
Tricuspid stenosis
D
Mitral stenosis
Question 4 Explanation: 
Ventricular septal defect is the only holosystolic (pansystolic) murmur in the answer set.
Question 5

While listening to the heart sounds of a premature infant you hear a continuous machine-like murmur. What is the most likely cause of this murmur?

A
Ventricular Septal Defect
B
Early closure of the foramen ovale
C
Tetrology of Fallot
D
Mitral valve regurgitation
E
Patent ductus arteriosus
Question 5 Explanation: 
A Patent Ductus Arteriosus (PDA) is classically described as a "continuous machine-like murmur." PDAs are associated with prematurity and congenital rubella infections. A Ventricular Septal Defect (VSD) is a harsh sounding murmur, but it is not continuous. VSDs are holosystolic sounds.
Question 6

Which of these could be an opening snap that becomes louder with inspiration?

A
Pulmonary stenosis
B
Mitral stenosis
C
Tricuspid stenosis
D
Aortic stenosis
Question 6 Explanation: 
Both Tricuspid stenosis and Mitral stenosis are described as "opening snap" sounds. If a heart sound gets louder on inhalation, this is a clue that the sound is coming from the right side of the heart; therefore, tricuspid stenosis is more likely the answer in this scenario.
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