Heart murmur sounds (cardiac auscultation sounds) | UKMLA | CPSA

Summary

This video demonstrates the clinical procedure for auscultating heart valves and assessing heart sounds using a stethoscope while monitoring the carotid pulse. The practitioner listens at specific intercostal spaces to assess the mitral, tricuspid, pulmonary, and aortic valves. Key maneuvers, such as breathing techniques and positional adjustments, are used to amplify heart murmurs like aortic stenosis and mitral valve regurgitation. Although the video aims to provide accurate information, it emphasizes the importance of professional clinical training and warns against relying solely on its content for clinical practice.

Takeaways

• 🩺 Listening to the heart while simultaneously feeling the pulse at the carotid artery is an important technique.
• ❤️ Mitral valve is auscultated at the fifth intercostal space along the midclavicular line.
• 💓 Tricuspid valve is located at the fourth intercostal space at the left sternal border.
• 💨 Pulmonary valve is auscultated at the second intercostal space at the left sternal border.
• 🔊 Aortic valve is auscultated at the second intercostal space at the right sternal border.
• 🎧 Reauscultate using the bell of the stethoscope for finer details.
• 📈 Systolic murmurs associated with aortic stenosis can be heard radiating during auscultation.
• 💪 Perform enhancement maneuvers to better hear aortic murmurs, especially during exhalation.
• 🌬️ Mitral valve murmurs can be enhanced by turning the patient to the left and during exhalation.
• ⚠️ The video emphasizes that the information provided should not replace professional clinical training and may contain errors.

Q & A

What is the purpose of listening to the chest while feeling the carotid pulse simultaneously?

The purpose is to identify the first heart sound (S1) by correlating it with the carotid pulse, as the first heart sound typically coincides with the pulse felt in the carotid artery.

Where should you place the stethoscope to listen for the mitral valve?

The stethoscope should be placed at the fifth intercostal space along the midclavicular line to auscultate the mitral valve.

What is the anatomical location for listening to the tricuspid valve?

To listen to the tricuspid valve, place the stethoscope at the fourth intercostal space along the left sternal border.

Where is the best location to auscultate the pulmonary valve?

The pulmonary valve is best auscultated at the second intercostal space along the left sternal border.

At which location can you listen for sounds from the aortic valve?

The aortic valve can be auscultated at the second intercostal space along the right sternal border.

What is the significance of auscultating with the bell of the stethoscope after using the diaphragm?

Using the bell allows better detection of low-pitched sounds, such as certain murmurs (e.g., mitral stenosis), which may not be heard as clearly with the diaphragm.

What is a common finding associated with aortic stenosis during auscultation?

A systolic mid-murmur that spreads, often radiating to the carotid arteries, is commonly associated with aortic stenosis.

How can you amplify the sound of an aortic murmur?

An aortic murmur can be amplified by having the patient exhale fully and hold their breath while sitting up, as this enhances the sound of aortic regurgitation or stenosis.

What maneuver can be used to amplify a mitral valve murmur?

A mitral valve murmur can be amplified by positioning the patient on their left side and having them exhale and hold their breath.

Why is it important to listen for mitral valve murmurs radiating to the axilla?

Listening for mitral valve murmurs radiating to the axilla is important because mitral regurgitation often radiates toward the left axilla, and this can help confirm the diagnosis.