Heart murmurs for beginners 🔥 🔥 🔥 Part 1:Aortic & Mitral stenosis, Aortic & mitral regurgitation.

Summary

In 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.