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

Mitral Regurgitation

Mitral Regurgitation is backflow through the mitral valve

1

When will mitral regurgitation occur? a) Systole b) Diastole c) Both Correct! The blood will flow back out of the ventricle into the atriaNo. In diastole blood will be going the correct way through the mitral valve, in systole however due to the incompetence of the valve the blood will leak back and create turbulenceYour answer has been saved.

2

Remembering the diagram of the four places in the chest which correspond to where you should listen for each valve, where is the mitral murmur likely to be loudest a) Axilla b) Carotids c) Right Sternal border d) Left Sternal border Correct, as you move towards the axilla the murmur of Mitral Regurgitation gets louder, and does NOT radiate to the carotidsNo, as you move towards the AXILLA the murmur of Mitral Regurgitation gets louder!Your answer has been saved.

In order to increase the sound of the murmur of mitral regurgitation, you can roll the patient slightly onto their left side (left lateral decubitus position) and listen in the axilla.

Another tip to increase the murmur sound (although not appropriate for every patient) is to suddenly increase the afterload on the heart; this can be accomplished by having the patient squeeze their hands together tightly. Squatting also increases venous return and will accentuate the murmur and standing will have the opposite effect.

Mitral regurgitation is a continuous constant sound through systole.

This is an audio example of MR. Notice how the murmur is constant in volume unlike AS.