Download - Heart Sounds & Murmurs
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Heart sounds and murmurs
Prof Anura Weerasinghe
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Objectives Heart sounds (including murmurs) & their
genesis
Correlation of heart sounds with cardiac
events
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enesis Heart sounds
!"udden changes in the rate of flow createvibrations which can be heard#
$urmurs
!%ue to turbulent blood flow ruits
!noise heard over blood vessels
'hrill!ibration as erceived b* the sense of touch
Rene Laennecinvented the stethoscoe#
(+,-+ ! +-./)
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Heart sounds Closing of the valves is associated with audible
sounds
0o audible sounds occur when valves oen
'he first heart sound
!associated with closure of the atrioventricular valves
'he second heart sound
!associated with closure of the semilunar valves
+st 111s*stole111 .nd111%iastole 111 +st
lub dub lub
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"litting of heart sounds 'he mitral valve closes slightl* before the
tricusid valve# ut the slitting of the firstheart sound is difficult to be detected b*
auscultation#
0ormall* ulmonar* valve closure alwa*sfollows aortic valve closure and the slitting
is widest during insiration# "litting can be
heard with the stethoscoe as the* are high1
itched sounds#
Pulmonar* valve closure is normall* heard onl* in ulmonar*
area and a short distance down the left sternal edge#
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u*ton .2/
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3rdand 2thheart sounds
3rdheart sound!heard about +43 of the wa* through diastole
!associated with raid ventricular filling!ma* be h*siological in health* *oung eole
2thheart sound!associated with atrial contraction
'hose sound are detected b*honocardiograh*
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$urmurs as a result of diseases
of the valves 0arrowed (stenosis)
!lood flow through it in the normal direction
roduces the murmur
5ncometent (insufficienc*)
!lood flow bac6ward through it roduces the
murmur (regurgitation)
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Heart murmurs
alve Abnormalit* 'iming ofmurmur
Aortic orulmonar*
"tenosis "*stolic
5nsufficienc* %iastolic
$itral ortricusid
"tenosis %iastolic
5nsufficienc* s*stolic
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Congenital heart diseases
Ac*anotic!entricular setal defect
Pan s*stolic murmur over the recordium
!Atrial setal defect
7jection s*stolic murmur over the PA due to
increased blood floor through the normal ulmonar*
valve
!Patent ductus arteriosus Continuous murmur
C*anotic
!8allot9s tetrolog*
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u*ton .:;
Patent %uctus Arteriosus
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u*ton .:+
8allot9s tetralog* "%
P" Overrding of the aorta
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u*ton .2/
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Objectives Heart sounds (including murmurs) & their
genesis
Correlation of heart sounds with cardiac
events