hearth valves and heart sounds

beginning of systole

s1 (lub)

end of systole

s2 (dub)

early diastole (middle third)

s3

late diastole (atrial contraction)

s4

closure of AV

s1

closure of semilunar

s2

rapid ventricular filling

s3

atrial contraction

s4

duration: 0.14 sec

s1

duration: 0.11 sec

s2

lower pitch

s1

higher pitch

s2

low rumble

s3

very low pitch

s4

when heard in children/young adults is normal

s3

usually abnormal heart sound in adults

s4

rbbb sound

s1

asd, rbbb sound

s2

heart failure

s3

lvh, reduce compliance

s4

• systolic murmur

• aortic area - 2nd ics

• harsh loud

• neck

aortic stenosis

blockage to flow forward

aortic stenosis or mitral stenosis

• systolic

• mitral area (apex)

• blowing, high pitch

• left axilla

mitral regurgitation

weak valves, flow backward

mitral regurgitation or aortic regurgitation

• diastolic

• aortic area & left sternal

• blowing, high pitch

• apex

aortic regurgitation

• diastolic

• mitral area (apex)

• low rumbling

• left axilla

mitral stenosis

• pulmonic area

• machinery murmur

• left clavicle

• continous flow from aorta to pulmonary artery

patent ductus arteriosus

stenosis primary problem

pressure overload

regurgitation primary problem

volume overload

AS compensation

CONCENTRIC lvh

AR compensation

ECCENTRIC lvh

mitral stenosis

left atrial enlargement

mitral regurgitation

left atrial enlargment

cause: senile calcific, bicuspid

aortic stenosis

cause: rheumatic, aortic dissection

aortic regurgitation

cause: rheumatic (most common)

mitral stenosis

cause: rheumatic, ischemic, functional

mitral regurgitation

consequence: syncope, angina, lvh, pulmonary edema

aortic stenosis and aortic regurgitation

consequence: atrial fibrillation, pumonary edema, RVH

mitral stenosis and mitral regurgitation

right to left shunt CHD

TOF

what CHD condition:

• l-r shunt

• fixed split s2

atrial septal defect

what CHD condition:

• l-r shunt

• holosystolic murmur

ventricular septal defect

what CHD condition:

• l-r shunt

• continous machinery murmur

patent ductus arteriosus