Heart Murmurs - (Part 2 of 3)

Lecture on the characteristics and identification of heart murmurs

Category:

Education

Tags:

• heart murmurs
• cardiac
• holosystolic
• systolic
• diastolic
• heart sounds
• cardiac auscultation

[drericstrong]

...so I don't usually use squatting to evaluate AS, but rather supine/sudden standing.

Regarding the question about example 1, I hope to have a video with diagrams and slowed audio up for you in the next day or so.

[drericstrong]

@Tholius: Thanks for the great questions. Regarding the response of aortic stenosis to squatting, I agree that what I say here seems a little contradictory. The best way to explain it is that squatting increases both afterload, and causes a relatively transient increase in preload. When someone with AS squats, the increased preload may have greater impact on murmur intensity than the increased afterload, thus the murmur can increase. This change is usually very subtle...

[beastwool1]

I do have a question. Why is example two aortic stenosis? I thought that a murmur presenting loudest in the right second intercostal space was indicative of pulmonic valvular disease?

[Tholius]

Other question I had was example 1, I have trouble with diastolic murmurs sometimes. This one sounds to me as "blow" S1, then S2, so i named it diastolic murmur. Then I listened again, and thought maybe it's S1 - S2 - S3 because it sounds like kentucky. Can you explain this a bit further, or have a tute on how to distinguish with a pic/slowing down of the sounds. I'm curious that's all thanks

[Tholius]

Hi, thank for you these. I am confused with one point so far. You mentioned initially that squatting increases venous return and that's how you differentiate aortic stenosis intensity from clenching fists which increases afterload. Then you mentioned at 3.56 that squatting also increases afterload... so if that's the case (& its true because thats what kids with ToF do) then aortic stenosis shouldn't really be increased in intensity with squatting??? Thanks

[ALGerulat]

Thank you so much for these videos! Very helpful for NP school! I think this will help me on my next cardiology exam.

[tuswei1]

You make it so easy to recognize these murmurs! I am definitely going to ace my exam this coming monday. Thanks!

[sassygirl33e]

thank u for people like u!