Heart Sounds

Question 1

First sign of heart pump failure

Answer 1

Lower limb edema

Indicates backup in the right side of the heart

Other areas: liver and neck (where SVC drains)

Question 2

Effect of enlarged heart to PMI

Answer 2

Moves laterally and down slightly

Can go as far as the axilla

Question 3

Use of percussion for cardiac evaluation

Answer 3

Check for pleural effusions/fluid buildup

Would be sign of congestive heart failure

Question 4

Left sided heart failure —>

Answer 4

Leads to fluid in the lungs

Question 5

No diagnosis can be made just from physical exam…need a

Answer 5

EKG

Question 6

Gallops (s3 and s4)

Answer 6

Sign that the chambers are anatomically abnormal

S3 = dilated cardiomyopathy, LV is big, caused by turbulent blood flow in the ventricles that haven’t ejected all the blood out from previous cycle

Immediately follows S2

Can be normal in heavy exercise people, or young people with hyper dynamic heart beats

S4 = hypertrophic cardiomyopathy…always BAD

Sound caused by vibrations of ventricle from it being too stiff and the atria must push against the harder and stiffer pressure to eject blood into it

Right before S1

Question 7

Murmurs

Answer 7

Abnormal flow of blood over leaky or stiff valves

Stenosis = caused by stiff valves…
—> if during systole = aortic
—> if during diastole = mitral

Leaky = happens when blood flow backwards through valve
—> aortic = diastole
—> mitral = during systole

Question 8

Friction rub

Answer 8

Pericarditis