Heart murmurs Flashcards
What heart sound does S1 stand for?
closing of the atrioventricular valve
What heart sound does S2 stand for?
closing of the semi-lunar valves
What does the S1 heart sound indicate?
Start of systolic contraction of ventricles
What does the S2 heart sound indicate?
End of systole
What causes the S3 heart sound?
Rapid ventricular filling, causing the chordae tendinea to strung
What does the S3 heart sound indicate?
Normal in young peeoplee, indicative of heart failure in older patients
What causes the S4 heart sound?
Caused by turbulent flow from atrium to non-compliant ventricle; extra arial pressure
What does the S4 heart sound indicate?
Always abnormal; stiff or hypertrophic ventricles
What can the S3 heart sound be heard?
Roughly 0.1 seconds after the second heart sound
What can the S4 heart sound be heard?
Directly before S1
When listening to the heart, where would you auscultate?
- 2nd intercostal space on the right → aortic valve
- 2nd intercostal space on the left → pulmonary valve
- 4th intercostal space on the left → tricuspid valce
- 4-5th intercostal space in mid-clavicular line → mitral valve
- Erbs point → best place to listen to the heart sounds S1 and S2
When listening to the heart, what special manoeuvres would you do to inspect murmers?
Roll patient over onto their left hand side to listen for mitral stenosis*
Sit the patient up, lean forward and breathe out and hold this for aortic regurgitation
How do you grade heart murmurs?
- Grade 1 → hard to hear
- Grade 2 → quiet
- Grade 3 → easy to hear
- Grade 4 → easy to hear with palpable thrill
- Grade 5 → can hear with stethoscope barely touching the chest
- Grade 6 → can hear with stethoscope off the chest
How would you hear mitral stenosis during auscultation?
Mitral stenosis causes mid-diastolic low-pitch rumbling murmur and loud S1
LUB-dub-drrrr
Malar flush → flushing of patient’s cheeks
How would you hear mitral regurgitation during auscultation?
High-pitched whistling murmur from S1 to S2
Lub Burrrrr
