Heart Sounds and Valve Disorders

Question 1

What is the S1 “LUB” sound?

Answer 1

Occurs as AV valves close and signifies beginning os systole, ventricular contraction

Question 2

What is the S2 “DUB” sound?

Answer 2

Occurs when SL valves close at the beginning of ventricular diastole

Question 3

What is the S3 sound?

Answer 3

Blood flowing into ventricles (usually not heard in healthy adult)

Question 4

What is the S4 sound?

Answer 4

Atrial contraction (usually not heard in healthy adults)

Question 5

Where do I listen for Heart sounds?

Answer 5

Aortic valve: 2nd intercostal space, right sternal border
Pulmonary valve: 2nd intercostal space, left sternal border
Tricuspid valve: 4th intercostal space, left sternal border
Mitral (bicuspid) valve: 5th intercostal space, left mud clavicular line

Question 6

Sustained noises that are audible during the time periods of systole, diastole, or both

Answer 6

Murmurs

Question 7

Causes of Murmurs

Answer 7

• Backwards regurgitation (leaky valve, septal defect)
• Forward flow (narrowed or deformed valve)
• High rate of flow (through normal or abnormal valves)
• Vibration of loose structures (chordae tendinae)

Question 8

Mechanisms for for Valve Disorders

Answer 8

1. Stenosis
2. Incomplete closure/ insufficiency
3. Prolapse

Question 9

Narrowing or constriction of the valve

Answer 9

Stenosis

Question 10

One or both valve leaflets protrude into the atrium or ventricle

Answer 10

Prolapse

Question 11

Blood back flow from one chamber to the next

Answer 11

Incomplete closure/ Insufficiency