Heart Sounds Tutorial

Table of Contents

1. Introduction
2. The Basics
3. Murmurs
4. Extracardiac Sounds
   1. Pericardial Rub
   2. Mediastinal crunch
5. MCQ
6. Acknowledgements and References

Mediastinal crunch

Air present in the mediastinum can produce a mediastinal crunch and this may also be referred to as Hamman's Sign

This sound occurs in ventricular systole (between S1 and S2) and is random in it's nature, i.e. it will not occur in any real pattern. Another way of looking at them are as crackles such as those found on respiratory examination BUT synchronised with heart beat and not respiration.

This sound can follow surgery but more commonly can be a spontaneous pneumothorax and is considered a medical emergency.