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 Stenosis

As with Mitral regurgitation this is heard best towards the axilla, accentuated by having the patient positioned on their left side (left lateral decubitus position)

A deep pitched murmur or rumble this is best heard with the bell of the stethoscope.

There is sometimes a sound just before the murmur itself and this is caused by a calcified valve snapping open.... So it's called the opening snap. (This can be hard to hear)

The above diagram shows different stages of MS, as you can see the opening snap moves closer to S2 as the severity increases and the murmur eventually becomes pan-diastolic and louder as the stenosis worsens.

The audio below is of MS, and I strongly recommend you do not listen to it on laptop speakers as the murmur is low pitched and cannot easily be heard.