Rahul’s noteblog heart sounds and murmurs gas efficient suv 2013

Stiff and hypertrophied ventricles; hypertrophic cardiomyopathy; ventricular hypertrophy due to hypertension; ischemic heart damage due to acute myocardial infarction; immediately precedes S 1 heart sound; ventricular gallop; left-sided S 4 is heard best in left lateral decubitus position while expiring; right-sided S 4 is heard best in the lower left sternal border while the patient lies in supine position; may be normal in children and young adults.

Diastolic murmur in upper left sternal border (precordium); Marfan’s Syndrome; early diastolic decrescendo murmur radiating to the apex; early high-pitched blowing diastolic murmur; diastolic decrescendo murmur at the right upper sternal border; wide pulse pressure; head bobbing with each heart beat; bounding pulse; often accompanied by diastolic "blowing" murmur (i.e., an aortic regurgitation murmur); Pulsus bisferiens; Corrigan pulse (rapid rise and fall of peripheral pulses):

Mid-systolic click over the cardiac apex with accompanying short systolic murmur if mitral regurgitation is present; murmur disappears with squatting. Asymptomatic in young people and often goes undiagnosed. Midsystolic click followed by late systolic murmur; "apical systolic murmur:"

Crescendo-decrescendo mid-systolic ejection murmur radiating to the neck; weak and late pulses; harsh systolic murmur; "diamond-shaped;" may be preceded by an opening click; pulsus parvus et tardus; slow-rising carotid pulse; paradoxical splitting of S 2; delayed carotid upstroke with systolic ejection murmur at second intercostal space at the right sternal border; soft S 2 without splitting may be present; systolic thrill; forceful apex beat:

Exaggeration of normal physiology; pericarditis (enlarged heart, but not as enlarged as in hypertrophic cardiomegaly); drop in systolic BP during inspiration; also heard in pericardial tamponade; may be due to bacterial infection. Drop in systolic blood pressure greater than 12 mm Hg during inspiration. May be due to tension pneumothorax or severe asthma.

Crescendo-decrescendo murmur; syncope; intraventricular septal hypertrophy. Outflow obstruction, arrhythmias, ischemia may lead to syncope. Repeated dyspnea, ejection-type systolic murmur decreases with squatting. Autosomal dominant. Pulsus bisferiens (biphasic pulse) – two strong systolic peaks of aortic pulses from left ventricular ejection separated by a midsystolic dip. Crescendo-decrescendo murmur at left lower sternal border; abnormal mitral leaflet motion. Murmur increases in intensity during Valsalva maneuver due to decreased preload and decreased filling of the left ventricle. Hypertrophied IV septum causes outflow obstruction. Harsh systolic murmur in aortic area at right upper sternal border:

Cough and clear nasal discharge; poor feeding, blood pressure is 80/60 mm Hg in the arms and 84/64 mm Hg in the legs; grunting, nasal flaring, and intercostal retractions; pale and mottled skin. Scattered crackles and expiratory wheezes are heard on auscultation. A grade 4/6 systolic murmur is heard across the precordium radiating to the carotid arteries. An x-ray of the chest shows cardiomegaly and pulmonary edema. An ECG shows left axis deviation with tall T waves in leads V 4 through V 6.:

Holosystolic or diastolic murmur near fourth intercostal space at the mid-clavicular line; complication of tetralogy of Fallot surgical repair, Rheumatic fever or infective endocarditis. Systolic thrill palpated at the left sternal border; murmur increases with inspiration and decreases with Valsalva maneuver. An extra heart sound is heard after diastole and a widely split second heart sound:

• Right-sided murmurs increase on inspiration and left-sided murmurs increase on expiration. The bell of a stethoscope is well-suited to detect low frequency sounds like the S 3, while the diaphgram is best for hearing high-pitched sounds like S 1 and S 2.

• Murmurs in pregnancy: systolic murmurs are found in 90% of women and need no workup; diastolic murmurs are bad and an echo would be needed to further evaluate them. Heart Sounds drawn on the Cardiac Cycle: Additional Reading: Basic Cardiology