Heart murmurs for beginners 🔥 🔥 🔥 Part 1:Aortic & Mitral stenosis, Aortic & mitral regurgitation.
Summary
TLDRIn this episode of the Learn Medicine Show, Dr. Coleman explores four common heart murmurs, explaining their causes and characteristics. He begins with the basics of heart sounds, then delves into systolic murmurs like aortic stenosis and mitral regurgitation, and diastolic murmurs including aortic regurgitation and mitral stenosis. Using the LUB-WOOSH-DUB schema and sound wave visuals, he helps listeners identify and understand these murmurs, providing insights into their clinical presentations and significance in cardiology.
Takeaways
- 📚 The script is an educational video by Dr. Coleman on the Learn Medicine Show, focusing on heart murmurs and their identification in medical exams.
- 💓 Basic heart sounds are represented as S1 and S2, with S1 sounding like 'LUB' and S2 like 'DUB', and the gaps between them are systole and diastole, respectively.
- 🔍 Heart murmurs are caused by disruptions in blood flow, resulting in turbulence that produces audible vibrations, which are documented in heart sound diagrams.
- 🚀 The first murmur discussed is aortic stenosis, characterized by an ejection systolic murmur with a crescendo-decrescendo sound wave, remembered by 'LUB-WOOSH-DUB'.
- 🌊 Aortic stenosis is due to the narrowing of the aortic valve, leading to turbulent blood flow and symptoms like angina, syncope, and dyspnea.
- 📉 Mitral regurgitation is another systolic murmur, described as pan-systolic with a plateau waveform, so loud it can drown out S1 and S2, and is associated with conditions like mitral valve prolapse.
- 🌐 The murmur of mitral regurgitation is loudest at the heart's apex and can radiate to the left axilla, with clinical signs including a displaced apex beat and peripheral edema in severe cases.
- 🔁 Aortic regurgitation is a diastolic murmur heard during early diastole with a decrescendo waveform, often described as 'lub-tar', and can be caused by rheumatic fever or connective tissue diseases.
- 📍 Aortic regurgitation's murmur is loudest at the left sternal edge, with clinical signs such as a collapsing pulse and a wide pulse pressure.
- 📉 Mitral stenosis causes a mid-diastolic murmur with an opening snap and a decrescendo waveform, described as 'lub-di-der', and is commonly due to rheumatic fever.
- 🎵 The murmur of mitral stenosis is heard loudest at the apex, with clinical signs including malar flush and a tapping apex beat, and is associated with symptoms like dyspnea and palpitations.
Q & A
What is the basic unit of heart sounds in medical notes?
-The basic unit of heart sounds in medical notes is represented as S1, S2, and S1 again, which signifies one movement through the cardiac cycle.
What are the phases of the cardiac cycle referred to as systole and diastole?
-Systole refers to the gap between S1 and S2, which is the contraction phase of the heart. Diastole is the gap between S2 and the next S1, which is the relaxation phase of the heart.
How are the normal heart sounds S1 and S2 typically described?
-The normal S1 heart sound is often described as sounding like 'LUB,' while the S2 sound is described as 'DUB.'
What causes a heart murmur?
-Heart murmurs occur when there is a disruption of normal laminar blood flow, which can be caused by physiological or pathophysiological conditions, leading to turbulent flow and audible vibrations.
What type of murmur is associated with aortic stenosis?
-Aortic stenosis is associated with an ejection systolic murmur, characterized by a crescendo-decrescendo sound wave.
How is the murmur of aortic stenosis typically recognized and remembered?
-The murmur of aortic stenosis can be recognized and remembered using the schema LUB-WOOSH-DUB.
What are the common causes of aortic stenosis?
-The common causes of aortic stenosis include age-related calcification, congenital bicuspid valve, and rheumatic fever.
What is the characteristic murmur of mitral regurgitation?
-Mitral regurgitation is characterized by a pan-systolic murmur, which occurs throughout the entire duration of systole and has a plateau waveform.
How does mitral regurgitation affect the heart sounds?
-Mitral regurgitation causes a loud murmur that drowns out both S1 and S2, resulting in a burbling sound being heard instead.
What are the typical clinical presentations of aortic regurgitation?
-Aortic regurgitation may present with a smear in the clinical history and symptoms such as angina.
How is the murmur of mitral stenosis described and what does it indicate?
-The murmur of mitral stenosis is described as a mid-diastolic murmur with an opening snap and a decrescendo sound wave, indicating turbulent flow due to the narrowed mitral valve.
What are the common causes of mitral stenosis?
-The most common cause of mitral stenosis is rheumatic fever, with less common causes including congenital heart disease and systemic diseases such as lupus.
What clinical signs might be observed in a patient with mitral stenosis during examination?
-Clinical signs in a patient with mitral stenosis may include dyspnea, palpitations if atrial fibrillation is present, malar flush, and a tapping apex beat.
Outlines
📚 Introduction to Heart Murmurs and Sounds
Dr. Coleman introduces the topic of heart murmurs in the context of medical exams, emphasizing the importance of understanding basic heart sounds (S1 and S2) and the cardiac cycle phases (systole and diastole). He explains that murmurs arise from disruptions in blood flow, which can be due to physiological or pathophysiological conditions. The episode aims to familiarize viewers with normal heart sounds and then introduce murmurs, starting with systolic murmurs such as aortic stenosis, characterized by an ejection systolic murmur with a crescendo-decrescendo pattern.
🔍 Aortic Stenosis and Mitral Regurgitation Murmurs
The script delves into the specifics of aortic stenosis, detailing its cause by the abnormal narrowing of the aortic valve and its clinical presentation, which includes angina, syncope, and dyspnea. The murmur is best heard in the aortic region and apex of the heart, with radiation towards the carotid arteries. It is then contrasted with mitral regurgitation, which presents a pan-systolic murmur that overrides S1 and S2, and is caused by the abnormal closure of the mitral valve. Clinical signs include dyspnea and fatigue, with the murmur loudest at the apex and radiating into the left axilla.
🎵 Diastolic Murmurs: Aortic Regurgitation and Mitral Stenosis
The script moves on to diastolic murmurs, starting with aortic regurgitation, an early diastolic murmur caused by the incomplete closure of the aortic valve, allowing blood to regurgitate. This results in a decrescendo murmur best heard at the left sternal edge. Causes include rheumatic fever and connective tissue diseases. The second diastolic murmur discussed is from mitral stenosis, characterized by a mid-diastolic murmur with an opening snap due to the narrowed mitral valve. The murmur is heard loudest at the apex and radiates to the axilla, with causes ranging from rheumatic fever to congenital heart disease and systemic diseases like lupus.
👋 Conclusion and Engagement Invitation
Concluding the tutorial, Dr. Coleman invites viewers to engage with the content by liking, subscribing, sharing, and commenting their thoughts. He thanks the viewers for watching and hints at future episodes, promising more informative content in the Learn Medicine Show series.
Mindmap
Keywords
💡Heart Murmurs
💡Systole
💡Diastole
💡Aortic Stenosis
💡Mitral Regurgitation
💡Aortic Regurgitation
💡Mitral Stenosis
💡Ejection Systolic Murmur
💡Pan-Systolic Murmur
💡Decrescendo
💡Opening Snap
Highlights
Introduction to the Learn Medicine Show covering four heart murmurs in exams.
Explanation of basic heart sounds represented as S1, S2, and S1, detailing cardiac cycle phases.
Description of normal heart sounds 'LUB' for S1 and 'DUB' for S2.
Murmurs result from disruptions in blood flow, causing audible vibrations.
Introduction to systolic murmurs, starting with aortic stenosis.
Aortic stenosis produces an ejection systolic murmur with a crescendo-decrescendo sound wave.
Memory aid 'LUB-WOOSH-DUB' for recognizing aortic stenosis murmur.
Cause of aortic stenosis includes age-related calcification and congenital bicuspid valve.
Clinical signs of aortic stenosis include angina, syncope, and dyspnea.
Mitral regurgitation causes a pan-systolic murmur throughout systole with a plateau waveform.
Mitral regurgitation's murmur is so loud it can drown out S1 and S2.
Causes of mitral regurgitation include mitral valve prolapse and ischemic heart disease.
Clinical presentation of mitral regurgitation with dyspnea and fatigue.
Introduction to diastolic murmurs starting with aortic regurgitation.
Aortic regurgitation produces an early diastolic murmur with a decrescendo sound wave.
Causes of aortic regurgitation include rheumatic fever and connective tissue diseases.
Mitral stenosis creates a mid-diastolic murmur with an opening snap and decrescendo wave.
Mitral stenosis is commonly caused by rheumatic fever and presents with dyspnea.
Conclusion of the tutorial with an invitation for feedback and future episodes.
Transcripts
Hello, and welcome back to the Learn Medicine Show. My name is Dr. Coleman,
and in this episode, we are covering four heart murmurs that typically come up in exams.
We're going to start by covering the basic heart sounds, and then we'll add
in the murmurs so that you can get to know them. Let's get into this.
Heart sounds can be graphically represented in medical notes as S1, S2, and S1 again,
and this represents one movement through the cardiac cycle.
The gap between S1 and S2 is known as systole, and the gap between S2 and S1 is known as diastole.
Before we start adding in murmurs, I want you to be familiar with the normal heart sound. So let's
briefly cover these. The S1 heart sound usually sounds like the word "LUB," and the S2 "DUB."
Let's add in the heart sounds briefly so you can familiarise yourself with this.
Now let's turn our attention towards heart murmurs. Murmurs occur when there
is a disruption of normal laminar blood flow. The disruption can be
caused by physiological or pathophysiological conditions, and this leads to turbulent flow,
which produces audible vibrations. These audible vibrations vary in their volume
based on the turbulent flow produced. These pictorial representations of sound waves
are what we use to document murmurs in our heart sounds diagram. So let's get down to business
now and start by looking at systolic murmurs. Our first systolic murmur is aortic stenosis.
Aortic stenosis typically produces what's known as an ejection systolic murmur. This
is a murmur that occurs during systole and is represented by a crescendo-decrescendo sound wave.
One strategy for recognising and remembering this murmur is using the schema LUB-WOOSH-DUB.
We'll now add in the murmur and heart sounds so you can fully appreciate this.
This murmur is produced by the abnormal narrowing of the aortic valve.
Let's take a closer look now at how this occurs.
Blood flows from the atria into the ventricles,
and the first heart sound is produced by the closure of the tricuspid and mitral valves.
Systole then occurs. The ventricles contract, forcing blood through the
pulmonary and aortic valves. Narrowing of the aortic valve creates turbulent blood flow
through the aortic valve. It is this turbulent blood flow that produces our crescendo-decrescendo
murmur. Finally, the S2 heart sound is produced by the closure of the pulmonary
and aortic valves. Let's now add in the murmur so that you can appreciate this in real-time.
"Now that we've heard the murmur, let's take a closer look at aortic stenosis. Aortic stenosis
is caused by abnormal narrowing of the aortic valve, and the aetiology includes age-related
calcification, congenital bicuspid valve, and rheumatic fever. The clinical history will
typically include angina, syncope, and dyspnea. The murmur of aortic stenosis is characterised as
an ejection systolic murmur. The murmur is louder in expiration and heard best in the aortic region
and in the apex of the heart. The murmur radiates in the direction of blood flow towards the carotid
arteries. On clinical examination, you may also find a slow-rising pulse and low blood pressure.
Let's turn our attention to mitral regurgitation. Here we have another systolic murmur, but this
time it's described as a pan-systolic murmur. As you may have already gathered from its name, this
occurs throughout the entire duration of systole. This murmur is represented visually with a plateau
waveform, meaning that the volume of the murmur remains consistent throughout its duration.
The murmur is so loud that it drowns out S1 and S2,
and instead, a burbling sound is heard. Let's pause and take a quick listen to this now.
This pan-systolic murmur is caused by abnormal closure of the mitral valve. Let's take a closer
look to get a better understanding of this. So, blood flows from the atria through the mitral
and tricuspid valves into the ventricles, and at this point, the mitral and tricuspid valves would
normally close to produce our S1 heart sound. But instead of this, the mitral valve prolapses into
the left atrium, and this causes turbulent blood flow, which generates a murmur that drowns out the
S1 and the S2 heart sound. Let's add in the murmur so that you can appreciate this in real-time.
Mitral regurgitation is caused by abnormal closure of the mitral valve, and this can
be due to a number of reasons, including mitral prolapse, ischemic heart disease, rheumatic fever,
and infective endocarditis. The clinical history will usually include dyspnea and fatigue."
Mitral regurgitation produces a pan-systolic murmur that is loudest at the apex of the heart
and radiates into the left axilla. Other signs you may see on examination include
a displaced apex beat and a parasternal heave. In severe cases, you may see peripheral oedema.
Let's now turn our attention towards diastolic murmurs, and we're going to cover two.
The first one is aortic regurgitation. This murmur is heard during diastole
and is considered an early diastolic murmur. It is represented pictorially with a decrescendo
sound wave. The words "lub-tar" can be used to describe how this murmur sounds.
Let's listen to this in real time so you can appreciate this better.
Aortic regurgitation is caused by abnormal closure of the aortic valve.
Let's take a closer look at this using animation. The first heart sound is produced by the closure
of the tricuspid and mitral valves. Systole occurs when the ventricles contract,
forcing blood through the pulmonary and aortic valves. Incomplete closure of the
aortic valve allows blood to regurgitate back into the ventricle. This turbulent blood flow
causes our diastolic murmur. Let's now add in the heart sounds and watch this occur in real time.
Aortic regurgitation is caused by abnormal closure of the aortic valve.
This may occur due to rheumatic fever but is also seen in connective tissue diseases
such as Marfan's syndrome and rheumatological conditions like rheumatoid arthritis and lupus.
Another possible cause is infective endocarditis. The clinical history
will usually present with the smear, and the patient may present with symptoms of angina.
Aortic regurgitation produces an early diastolic murmur that is her loudest at the left sternal
edge and radiates towards the apex of the heart. Other signs you might see on clinical examination
include a collapsing pulse, a wide pulse pressure, and a displaced apex beat.
Now let's turn our attention to our final murmur, the murmur of mitral stenosis.
Mitral stenosis produces a diastolic murmur that is described as a mid-diastolic murmur. It has
an opening snap and a decrescendo sound wave, meaning it starts loud and then becomes quieter.
To help recognise this mid-diastolic murmur, the terms "lub-di-der" are often used. Let's
pause for a moment to listen to this in real-time so that you can appreciate this better. [Music]
Mitral stenosis, as its name suggests, is caused by abnormal narrowing of the mitral valve.
Let's now take a look at an animation to see how this narrowing causes the murmur.
The S1 heart sound is produced by the closure of the tricuspid and mitral valves. Systole
then occurs, where ventricular contraction pushes blood through the pulmonary and aortic valves.
Closure of the pulmonary and aortic valves produces the S2 heart sound.
But milliseconds after this, accumulated blood in the left atrium increases the left atrial pressure
to a point where the stiffened mitral valve is forced open, and this produces an opening snap.
Almost immediately after S2, blood rushes through the narrowed mitral valve, producing turbulent
flow, and this is audible vibrations from these that produce our mid-diastolic decrescendo murmur.
Let's take a moment now to add in the murmur so you can appreciate it in real-time. [Music]
Mitral stenosis is an abnormal narrowing of the mitral valve.
The most common cause of this is rheumatic fever, and less common causes include congenital heart
disease and systemic diseases such as lupus. The clinical history typically presents with dyspnea
and palpitations if atrial fibrillation is present. Mitral stenosis produces a mid-diastolic
murmur with an opening snap that is heard loudest at the apex and radiates to the axilla. Other
signs that you may see on clinical examination include malar flush and a tapping apex beat.
And that brings us to the end of the tutorial. So, if you enjoyed this, please
like and subscribe, share with your friends, and let me know what you think in the comments below.
Thanks for dropping by. I'll see you again soon.
関連動画をさらに表示
Viva Questions of CVS by Dr Junaid
Heart murmurs for beginners Part 2: Atrial septal defect, ventricular septal defect & PDA🔥🔥🔥🔥
Auscultation of Heart Sounds | Assessing Heart Sounds | Listening to the Heart with a Stethoscope
2DEcho || How to READ 2DEcho report || Echocardiography • Daily Cardiology
Lub Dub | Circulatory system physiology | NCLEX-RN | Khan Academy
Heart Valves (Atrioventricular and Semilunar) Heart Valves | Physiology | Lecturio Nursing
5.0 / 5 (0 votes)