1. Cardiac Heart Sounds Flashcards
What is S1 heart sound?
Closure of AV valves (mostly mitral and tricuspid) - better heard with mitral valve because this is primary source of sound
Where is best place to hear S1?
Below Erbs point at 3rd ICS
What is S2
- aortic valve closing from pressure from in left ventricle
Why would an S2 have less intensity than normal?
less pressure build up in LV or possible decreased peripheral resistance
What causes S3?
- LV overload or failure
- Common in abnormal stiffness or myocardium and high filling pressures
- High left atrial pressure can create high pressure across the mitral valve followed by rapid increase in LV pressure–> non compliant LV produces S3 sound
When does S3 occur?
In diastole just after S2
What is
- Forceful atrial contraction into a non-compliant ventricle
- RIght before s1
- Almost always associated with increased LV end diastolic pressure
S4
What is the issue with diastolic dysfunction
- decreased compliance or distensibility of the ventricle
- increased LV end diastolic pressure
abnormal prolonged ventricular relaxation impairs early diastolic ventricular filling
What is needed to hear S4?
- low pitch sound typically heard at the apex with the bell
- need to listen in the left lateral decubitus position so that it is not missed
What condition has an opening snap and late systolic murmur?
Mitral valve prolapse
What sx can be associated with mitral valve prolapse ?
- palpitations
- dyspnea
- exercise intolerance
- dizziness
Who would be expected to have mitral valve prolapse?
- thin, tall, young woman
- associated with CT diseases like Marfan or Ehlers danlos
Mid systolic click and/or murmur of mitral regurge
suggests mitral valve prolapse
Systolic murmur best hear at base of heart that can produce S4?
Aortic stenosis
Cresendo decrescendo systolic murmur?
Aortic stenosis
