IT IS AN BRIEF DESCRIPTION ABOUT SIMPLE ASSESMENT OF HEART , ANATOMY & PHYSIOLOGY OF HEART ,HEART SOUNDS, NORMAL & ABNORMAL SOUNDS..ESPECIALLY MOST USEFULL TO NURSES...

1. PREPARED BY
MURUGESH H J
ICU 02
KING FAHD CENTRAL HOSPITAL JIZAN
SAUDI ARABIA

2.  as we know heart is structural & key element
for blood circulation , each beat will pump
blood to whole body , maintains whole body
blood circulation ….
 when blood is flowing in heart BECAUSE OF
CLOSURE OF THE VALVES , DIFFERENT
SOUNDS WILL BE PRODUCED THESE ARE
THE HEART SOUNDS”.. ( four main heart
valve areas: the aortic, pulmonary, tricuspid
and mitral valve areas)
 LETS BEGIN OUR DISCUSSION …

3. Types Of Heart Sounds
 S1 – “lub” caused by the closing of the
AV valves.
 S2 – “dub” caused by the closing of
semilunar valves.
 S3 – linked with flow of blood into the
ventricles.
 S4 – linked with atrial contraction.

4. What are S1 S2 S3 and S4 heart sounds?
 In a healthy adult, the heart makes two sounds,
commonly described as 'lub' and 'dub. ' The
third and fourth sounds may be heard in some
healthy people, but can indicate impairment of
the heart function. S1 and S2 are high-pitched
we can auscultate in the Bell part of the
stethoscopre and S3 and S4 are low-pitched
sounds usually diaphragm portion

5.  The S3 heart sound is a low-pitched sound that can
hear when blood rushes rapidly from the heart's
atrium into the ventricle Sometimes, particularly in
children and athletes, it is a typical sound we can
hear , but in normal persons it is a classical indicator
for CHF ..
A S4 heart sound can be an important sign of diastolic heart
failure or active ischemia and is rarely a normal finding.
Diastolic heart failure frequently results from severe left
ventricular hypertrophy, or LVH, resulting in impaired
relaxation (compliance) of the LV. In this setting, a S4 is often
heard.

6. A heart murmur is a blowing, whooshing, or rasping sound heard
during a heartbeat. The sound is caused by turbulent (rough) blood
flow through the heart valves or near the heart….. Heart murmurs
can be present at birth (congenital) or develop later in life (acquired).
Some heart murmurs are harmless (innocent). An innocent heart
murmur is not a sign of heart disease and doesn't need treatment.
Other heart murmurs may be a sign of a serious heart condition. Tests
are needed to check the heart and heart valves. Heart murmur
treatment depends on the cause
Types of murmurs include:
 Systolic murmur. This happens during a heart muscle contraction.
...
 Diastolic murmur. This happens during heart muscle relaxation
between beats. ...
 Continuous murmur. This happens throughout the cardiac cycle.

9.  Ask the verbal consent from the patient if
conscious, follow patient privacy
 start Examination with assessment or
observation , auscultation …
 Do hand hygiene , clean stethoscope with
alcohol swab before & after usage
 while assessing for low pitched sounds use
Diaphragm part of stethoscope & for High
pitched sounds use Bell of the stethoscope..

10.  Start from A, P, T, M Manner ( aortic,
pulmonic, tricuspid & mitral valve manner )
 If you any confusion call & reconfirm the
findings with your seniors ..
 If any abnormality detected means inform
immediately to the doctors
 Document the findings & procedure in your
notes
 Say thanks to your patient , conclude the
procedure..

11. THANKS
TO ALL