Heart Sounds Flashcards
What are the valve auscultation areas
What is S1?
Closure of the atrioventricular valves at the beginning of ventricular systole
M1= mitral valve
T1= tricuspid valve
What is S2?
Closure of the semi-lunar valves at the end of ventricular systole
A2 =aortic valve (precedes P2 during inhalation where splitting can be heard)
P2= pulmonary valve
What causes the physiological splitting of S2?
- Physiological split
- Occurs normally during inhalation because the decrease in intrathoracic pressure increases the time needed for pulmonary pressure to exceed RV pressure
What causes pathological splitting of S2?
LBBB
Pulmonary Stenosis
Atrial septal defect
What is S3?
- Ventricular gallop
- Occurs after S2 at the beginning of diastole
- Lower pitched and not of valvular origin
- Oscillation of blood back and forth the walls of the ventricles initiated by blood rushing in from the atria
- Benign in young adults or athletes
- CHF
What is S4?
- Presystolic
- CHF or LVH (HTN, valvular aortic stenosis, hypertrophic cardiomyopathy)
- Just after atrial contraction at the end of diastole and immediately before S1
- Best heard at cardiac apex in the left lateral decubitus position holding their breath
What are the causes of systolic murmurs?
Mid-systolic:
- Aortic stenosis/sclerosis
- Pulmonary stenosis/sclerosis
- Atrial septal defect
- Hypertrophic obstructive cardiomyopathy
Holo-systolic:
- Mitral regurgitation
- Tricuspid regurgitation
- VSD
Late systolic murmur:
- Mitral valve prolapse
What are the causes of diastolic murmurs?
Early diastolic:
- Aortic regurgitation
- Pulmonary regurgitation
Mid-diastolic:
- Mitral stenosis
- Tricuspid stenosis
What are the causes of continuous murmurs?
- PDA
- AV fistula
- Ruptured sinus of valsalver
- Prosthetic aortic valve
What increases left-sided murmurs?
Expiration
