Term
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Definition
Closure of tricuspid/mitral valves
Lub sound
Best heard at apex |
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Term
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Definition
Closure of the aortic/pulmonary valves
A2/P2
Dub sound
Best heard at right/left 2nd intercostal respectively
Physiologically split due to right ventricle depolarizing earlier, left ventricle has greater volume, and increased venous return on inspiration |
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Term
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Definition
Paradoxical splitting = LBBB or aortic stenosis
Fixed splitting = ASD or right-sided heart failure |
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Term
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Definition
| An abnormal S2 heart sound due to diseases in which the left ventricle takes longer to empty than the right ventricle such as aortic stenosis or LBBB. Normally, physiological splitting makes the A2 and S2 sounds get further apart during inspiration. In LBBB or aortic stenosis, upon inspiration P2 and A2 sound closer together instead of farther apart thus the paradoxical splitting. |
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Term
| Normal physiological splitting |
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Definition
| In S2, A2 comes before P2 but the sounds are close enough together that they can't be detected (expiration). During inspiration, venous return increases causing a larger amount of blood to have to be pumped across the pulmonic valve thus causing a delay in the closure of the pulmonic valve thus lengthening the split between A2 and P2. |
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Term
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Definition
| This is when S2 does not change during inspiration and is due to persistent increases in venous return either through an ASD, VSD, or right-sided heart failure. |
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Term
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Definition
| Occurs during early diastole and is due to reduced ventricular wall compliance from increased volume/filling pressure such as that found in CHF. Sounds like Ken-tuc-ky. |
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Term
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Definition
| Presystolic sound heard due to blood entering a stiff/noncompliant ventricle wall (lost ventricular compliance). Due to hypertension. Sounds like Tenn-es-see |
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Term
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Definition
Diastole
Deformed AV valve esp mitral stenosis |
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Term
| Systolic or ejection clicks |
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Definition
early systole
aortic or pulmonic stenosis |
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Term
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Definition
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Term
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Definition
Grade 1 = low intensity, not heard by inexperienced
Grade 2 = low intensity, heard by inexperienced
Grade 3 = medium intensity w/o thrill
Grade 4 = medium intensity w/ thrill
Grade 5 = loudest murmur heard when placing stethescope on chest, thrill
Grade 6 = audible w/o stethescope, thrill |
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Term
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Definition
Common symptoms of angina, syncope, CHF
Loudest at 2nd LICS (aortic area)
Radiates to carotids/apex
Crescendo-decrescendo due to LVH
Associated signs
- decreased A2
- S4
- Narrowed pulse pressure
- delayed upstroke |
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Term
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Definition
Pathophysiology:
- increased stroke volume and EDV due to backleak from aorta
- LVH due to increased volume preload, afterload
Chronic = left ventricle failure
Acute = dyspnea, pulmonary edema, hypotension
Physical findings:
loudest at aortic area
no radiation
decrescendo
blowing murmur
Associated signs
- S3
- lateral placed PMI
- wide pulse pressure
- bounding pulses |
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Term
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Definition
Common symptoms:
- dyspnea
- fatigue
- hemoptysis
- palpatations
- neurological = transient numbness/weakness of extremities, sudden loss of vision, difficulty w/ coordination
Physical findings:
Loudest at apex
no radiation
decrescendo
rumbling
Associated signs:
- increase S1
- opening snap |
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Term
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Definition
Chronic MR = dyspnea, easy fatigue, palpatations
Acute MR = dyspnea, orthopnea, shock
Holosystolic murmur (distinguish from ASD and MR by radiation to axilla)
Blowing murmur
Occurs with aortic stenosis |
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