Heart Sounds & Murmurs Flashcards
What does S1 signal?
Start of systole
What happens in S1?
Closure of mitral and tricuspid valves
Where is S1 loudest?
Apex
What happens in S2?
Closure of aortic and pulmonary valves
What does S2 signal?
end of systole and beginning diastole
What can happen physiologically in S2?
Physiological splitting during inspiration
First component (aortic) is louder than second component (pulmonary)
lub-du-rub
How is S3 described?
early diastolic low frequency filling sound occurring immediately after S2
In who does S3 present in pathologically?
older patients with suspected/known cardiac disease
commonly due to LV systolic dysfunction
In who does S3 present in physiologically?
Healthy child/young person with no evidence of cardiac disease
Describe S4
Late diastolic low frequency filling sound occurring just before the 1st heart sound. This relates to the active filling of a stiff non-compliant ventricle by atrial contraction.
Da-lup-dup
What causes an innocent cardiac murmur?
turbulence of blood in the right ventricular outflow tract
when are innocent cardiac murmurs often loudest?
when circulation is hyperdynamic: pregnancy fever anaemia thyrotoxicosis
What is a cardiac murmur?
Audible turbulent blood flow
What kind of murmur would you hear in mitral stenosis?
mid diastolic rumbling murmur
Where does mitral stenosis radiate to?
Nowhere, it is localised to the apex
