What are two variations of extra diastolic murmurs?

What are two variations of extra diastolic murmurs?

• A. S3 and S4
• B. S1 and S2
• C. A2 and P2
• D. Midsystolic murmurs

Answer: (A)

The concept being tested is identifying extra heart sounds that occur during diastole. The two that fit this description are S3 and S4. An S3 happens early in diastole right after S2 when the ventricle fills rapidly; it’s a low-pitched “ventricular filling” sound that can be normal in children and young adults but may indicate volume overload or systolic dysfunction in older adults. An S4 occurs late in diastole just before S1, caused by atrial contraction against a stiff or noncompliant ventricle; it’s often associated with long-standing hypertension, LV hypertrophy, or ischemic heart disease, though it can be normal in trained athletes or in older individuals without pathology. These are extra diastolic sounds, not murmurs. In contrast, S1 and S2 are the primary heart sounds marking the start and end of systole, A2 and P2 are components of S2, and midsystolic murmurs occur during systole, not diastole.

The concept being tested is identifying extra heart sounds that occur during diastole. The two that fit this description are S3 and S4. An S3 happens early in diastole right after S2 when the ventricle fills rapidly; it’s a low-pitched “ventricular filling” sound that can be normal in children and young adults but may indicate volume overload or systolic dysfunction in older adults. An S4 occurs late in diastole just before S1, caused by atrial contraction against a stiff or noncompliant ventricle; it’s often associated with long-standing hypertension, LV hypertrophy, or ischemic heart disease, though it can be normal in trained athletes or in older individuals without pathology.

These are extra diastolic sounds, not murmurs. In contrast, S1 and S2 are the primary heart sounds marking the start and end of systole, A2 and P2 are components of S2, and midsystolic murmurs occur during systole, not diastole.