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Heart Sounds & Murmurs
The Stethoscope  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Positioning ,[object Object]
Listening Posts
Cardiac Cycle
Systolic vs. Diastolic  systole S1     S2 diastole
Gallops   systole S1     S2 S4   S3 diastole
S1 (lubb) ,[object Object],[object Object],[object Object],The first heart sound can usually be heard easily with both the bell and the diaphragm
Abnormal S1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
S2 (dub) ,[object Object],[object Object],[object Object],For the second heart sound the diaphragm is invaluable, with the stethoscope usually best placed at the base
Abnormal S2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
S3 Heart Sound  ,[object Object],[object Object],[object Object],[object Object],S3 is low frequency and thus best heard with the bell of the stethoscope at the apex while the patient is in the left lateral decubitus position.   .
S4 Heart Sound ,[object Object],[object Object],[object Object],[object Object],[object Object],It is heard best with the bell of the stethoscope at the apex.
Gallop Sounds Split S1 Split S2 S3 S4 Summation Gallop Gallops & Other Sounds Sound Answer Normal
Murmurs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Murmur Assessment ,[object Object],[object Object],[object Object],[object Object]
Murmurs Made Easy systole S1     S2 diastole
Murmurs 1 2 3 systole diastole S1 S2 ,[object Object],[object Object],[object Object]
Murmurs 1 2 3 ,[object Object],[object Object],[object Object],Systolic What is it? (What’s my Aortic Valve doing?) Grating Open AORTIC STENOSIS
Murmurs 1 2 3 ,[object Object],[object Object],[object Object],Systolic What is it? (What’s my Aortic Valve doing?) Blowing Closed MITRAL INSUFFICIENCY
Murmurs 1 2 3 ,[object Object],[object Object],[object Object],Diastolic What is it? (What’s my Aortic Valve doing?) Blowing Closed AORTIC INSUFFICIENCY
Murmurs 1 2 3 ,[object Object],[object Object],[object Object],Diastolic What is it? (What’s my Aortic Valve doing?) Grating Open MITRAL STENOSIS
Systolic Murmurs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Systolic Valvular Murmurs  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Systolic Valvular Murmurs ,[object Object],[object Object],[object Object],[object Object]
Systolic Valvular Murmurs ,[object Object],[object Object],[object Object],[object Object]
Systolic Valvular Murmurs ,[object Object],[object Object],[object Object],[object Object]
Patent ductus arteriosus ,[object Object],[object Object]
Ventricular septal defect ,[object Object],[object Object]
Atrial septal defect (ASD) is a congenital heart defect .   ,[object Object],[object Object],[object Object]
Diastolic Murmurs   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diastolic Valvular Murmurs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diastolic Valvular Murmurs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],These can sound alike but only aortic regurgitation will be associated with a bounding arterial pulses…”water hammer pulse” brisk femoral pulsation
Pericardial Friction Rub ,[object Object],[object Object],[object Object]
Intensity of Murmurs Murmur Grades Grade Volume Thrill 1/6 very faint, only heard with  optimal conditions no 2/6 loud enough to be obvious no 3/6 louder than grade 2 no 4/6 louder than grade 3 yes 5/6 heard with the stethoscope partially off the chest yes 6/6 heard with the stethoscope completely off the chest yes
Significant or not? ,[object Object],[object Object],[object Object],[object Object]
Sites for practice ,[object Object],[object Object],[object Object],[object Object],[object Object]
Now you have a whole new meaning to the phrase “listen to your heart.”

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Heart Sounds And Murmurs

  • 1. Heart Sounds & Murmurs
  • 2.
  • 3.
  • 6. Systolic vs. Diastolic systole S1 S2 diastole
  • 7. Gallops systole S1 S2 S4 S3 diastole
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14. Gallop Sounds Split S1 Split S2 S3 S4 Summation Gallop Gallops & Other Sounds Sound Answer Normal
  • 15.
  • 16.
  • 17. Murmurs Made Easy systole S1 S2 diastole
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35. Intensity of Murmurs Murmur Grades Grade Volume Thrill 1/6 very faint, only heard with optimal conditions no 2/6 loud enough to be obvious no 3/6 louder than grade 2 no 4/6 louder than grade 3 yes 5/6 heard with the stethoscope partially off the chest yes 6/6 heard with the stethoscope completely off the chest yes
  • 36.
  • 37.
  • 38. Now you have a whole new meaning to the phrase “listen to your heart.”

Editor's Notes

  1. !!