HEART SOUNDS

Normal heart sounds are noted as:

S1

S2

S1:

Due to closure of mitral and tricuspid valves

S2:

Due to closure of aortic and pulmonic valves

S1 and S2:

Lub dub

Abnormal heart sounds

Abnormal heart sounds

S3:

Due to poor ventricular compliance and turbulence

Low frequency

S4:

Due to exaggerated atrial contraction and turbulence

Low frequency

Ejection sound:

Due to forceful and rapid ejection of blood

Harsh higher frequency sound

Systolic click:

Due to prolapsed mitral or tricuspid valve

Opening snap:

Due to forceful opening of a stenotic mitral valve

Pericardial friction rub:

Due to increased pericardial fluid, leathery or squeaky door osund

Heart murmurs:

Due to rapid and forceful blood flow or blood flowing past stenotic area or regurgitation

Produce turbulence

Blood pressure:

Cuff acts at tourniquet

Turbulence is known as karatkoff

Phase 1 Korotkoff:

First clear sound is systolic

Phase II korotkoff:

Sounds now have muffle or swishing

Phase III korotkoff:

Sounds are loud and clear

Phase IV korotkoff:

Sounds abruptly become muffled, like whisper

Phase V:

Sounds disappear

Undercuffing:

Leads to over treatment of HTN

Overcuffing:

Can cause lower than actual readings leading to under tx of HTN

Infant HR:

100-130

Children HR:

80-100

Adults HR:

60-100

Ankle brachial index:

Measure arterial perfusion using doppler

BP measured in UE and in LE

Divide highest LE systolic by brachial systolic

Normal ratio is 1.0

Peripheral artery disease is .9 at rest or .85 following exercise