Heart Sounds Tutorial

Table of Contents

1. Introduction
2. The Basics
3. Murmurs
   1. Benign murmurs
   2. Murmurs II
   3. Aortic Stenosis
   4. Mitral Regurgitation
   5. Aortic Regurgitation
   6. Mitral Stenosis
   7. Tricuspid Valve
   8. Pulmonic Valve
   9. Ventricular Septal Defect
   10. Patent Ductus Arteriosus
   11. Atrial Septal Defect
   12. Coarctation of the Aorta
   13. Mitral Valve Prolapse
4. Extracardiac Sounds
5. MCQ
6. Acknowledgements and References

Benign murmurs

1	Regarding Murmurs Any murmur is bad news a) True b) False Correct, as you can tell by the page title there are such things as benign murmursHint, look at the page title!Your answer has been saved.

2	Regarding laminar flow Increasing flow through a vessel will disrupt laminar flow a) True b) False Correct, so turbulence will ensue No, trying to force too much fluid through a restriction will cause turbulence Your answer has been saved.

Ok, so assuming you understand the answers from those two questions what can we deduce?

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Regarding High Flow Murmurs Which of the following could produce a murmur from high flow? a) Pregnancy b) Hyperthyroidism c) Anaemia d) Sprinting 100m a) Correct! Pregnancy increases the demands put on the hearta) No, pregnancy increases the demands on the heart and so can cause a murmur by increasing blood flowb) Correct! Hyperthyroidism increases heart rate and contractility therefore forcing more blood out, which as discussed can cause a murmurb) No. Hyperthyroidism increases heart rate and contractility therefore forcing more blood out, which as discussed can cause a murmurc) Correct! In order to compensate for the anaemia the heart has to pump harder and faster = higher flow = murmurc) No. In order to compensate for the anaemia the heart has to pump harder and faster = higher flow = murmurd) Correct! Again your heart should be beating hard and fast if you've sprinted properly!d) No. Try ticking true!

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So we have concluded that a murmur can be caused by high flow. Is the murmur going to occur in Diastole? a) True b) False Correct! The murmur will occur in Systole as this is when the pumping of the ventricles occurs. The type of murmur is usually a Mid-systolic (ejection) murmurNo, try ticking false Your answer has been saved.

These 'innocent' murmurs will vary each time you examine the patient depending on their cardiac output and will not be above Grade 3, i.e. they should not be accompanied by a thrill.

This is an example of a benign / innocent murmur

Benign murmur