AnatomyDiseasesAnalytical, Diagnostic and Therapeutic Techniques and EquipmentPhenomena and Processes
Heart MurmursHeart AuscultationHeart SoundsPhonocardiographyPhysical ExaminationEchocardiographySystolic MurmursHeart
Systolic murmursContinuous murmursOutflow tractFunctional murmurStenosisRegurgitationLeft atriumHypertensionArterySystoleBenignValveApexPathologicEdemaVeinsDiastolicValvesVenous returnAuscultationAbnormal heart soundsContractionTurbulent blood flowDiagnosisLive birthsPhysiologicCongenital heart dRadiationCoughingDefectsEchocardiographyInfantsAbnormalitiesOccursExamIncrease in intensityCardiac cycleCharacteristicsRheumatic heart dIntensityDecrescendoDiseaseTurbulenceSystemicCardiologyBlood flowsOrificeInnocentTrunkSymptoms
Systolic murmurs2
  • Continuous murmurs are not placed into the categories of diastolic or systolic murmurs. (wikipedia.org)
  • Pathologic causes of systolic murmurs include atrial and ventricular septal defects, pulmonary or aortic outflow tract abnormalities, and patent ductus arteriosus. (aafp.org)
Continuous murmurs2
Outflow tract2
  • The pulmonary annulus and the right ventricular outflow tract (RVOT) may be narrowed as well. (medscape.com)
  • Pulmonic Stenosis Pulmonic stenosis (PS) is narrowing of the pulmonary outflow tract causing obstruction of blood flow from the right ventricle to the pulmonary artery during systole. (merckmanuals.com)
Functional murmur3
  • A functional murmur is a benign heart murmur that is primarily due to physiologic conditions outside the heart. (wikipedia.org)
  • An atrial septal defect is often confused with a functional murmur, but the conditions can usually be differentiated based on specific physical findings. (aafp.org)
  • This approach should also help them know when they can confidently reassure the parents of a child with a functional murmur that referral is unnecessary. (aafp.org)
Stenosis5
  • Defects may be due to narrowing of one or more valves (stenosis), backflow of blood, through a leaky valve (regurgitation), or the presence of abnormal passages through which blood flows in or near the heart. (wikipedia.org)
  • A large study called the Second Natural History Study of Congenital Heart Defects analyzed the treatment, quality of life, echocardiography findings, complications, exercise responses, and predisposition to endocarditis with regards to cardiac valvular disease, and pulmonary stenosis was found to be the most benign valvular lesion. (medscape.com)
  • The intensity of S 1 depends on the integrity and pliability of valvular cusps, the length of the PR interval (which governs the velocity of valve closure), the strength of ventricular contraction, the presence or absence of valvular stenosis or regurgitation, the position of the valve leaflets at end-diastole, and the amount of tissue between the heart and the stethoscope. (medscape.com)
  • Infrequently, classic tricuspid atresia involves a large VSD and mild pulmonic stenosis, resulting in pulmonary overcirculation. (merckmanuals.com)
  • These murmurs can be due to a narrowing (stenosis) in the mitral or tricuspid valves, or regurgitation in the aortic or pulmonary valves. (bluenethospitals.com)
Regurgitation6
  • Mitral Valve Prolapse murmur at mitral area Heart sounds of a 16-year-old girl diagnosed with mitral valve prolapse and mitral regurgitation. (wikipedia.org)
  • By doing so this will help find the presence of an aortic regurgitation murmur. (wikipedia.org)
  • Cardiogenic pulmonary edema in dogs results from left-heart volume overload (mitral regurgitation, endocardiosis) or dilated cardiomyopathy. (vin.com)
  • These murmurs are divided into two categories: ejection murmurs, caused by blood flow through a narrowed or irregular artery or valve, and regurgitation murmurs, where the blood flow goes back into one of the heart's chambers. (bluenethospitals.com)
  • In acute regurgitation, left atrial pressure rises abruptly, leading to pulmonary edema if severe. (health.am)
  • Mitral regurgitation (MR) is caused by the retrograde flow of blood from the left ventricle (LV) into the left atrium (LA) through the mitral valve (MV), causing a systolic murmur heard best at the apex of the heart with radiation to the left axilla. (nih.gov)
Left atrium4
  • When it is chronic, the left atrium enlarges progressively, but the pressure in pulmonary veins and capillaries rises only transiently during exertion. (health.am)
  • The systemic circuit originates in the left side of the heart and functions by receiving oxygen-laden blood into the left atrium from the lungs and flows one way down into the left ventricle via the mitral valve. (medscape.com)
  • Once gas exchange occurs in the lung tissue, the oxygen-laden blood is carried to the left atrium via the pulmonary veins, hence completing the pulmonary circuit (see the image above). (medscape.com)
  • 3. Also, during inspiration, left ventricular stroke volume decreases because blood is pooled in the dilated pulmonary vessels and dilated left atrium, which occurs due to increased negative intrathoracic pressure. (nursingjobsexam.com)
Hypertension1
Artery2
  • This can be done by palpating the carotid artery simultaneously while auscultating the heart. (medscape.com)
  • Transposition of the Great Arteries (TGA) Transposition of the great arteries (in this case, dextro-transposition) occurs when the aorta arises directly from the right ventricle and the pulmonary artery arises from the left ventricle. (merckmanuals.com)
Systole3
  • The cardiac cycle refers to events that occur during one heart beat and is split into ventricular systole (contraction/ejection phase) and diastole (relaxation/filling phase). (medscape.com)
  • First heart sound represents the beginning of systole. (nursingjobsexam.com)
  • Second heart sound signifies the end of clinical systole and closure of semilunar valves. (nursingjobsexam.com)
Benign1
  • One set of investigators 2 found that physicians were generally accurate in determining whether a murmur was benign or pathologic. (aafp.org)
Valve11
  • Heart murmurs are unique heart sounds produced when blood flows across a heart valve or blood vessel. (wikipedia.org)
  • Mitral Valve Prolapse murmur at tricuspid area Her heart sounds while holding her breath. (wikipedia.org)
  • Mitral Valve Prolapse murmur at tricuspid area after exercising Her heart sounds during recovery after running. (wikipedia.org)
  • Heart murmur Ventricular septal defect murmur in 14 year old female's heart, heard from the mitral valve area. (wikipedia.org)
  • Our data suggest that B. quintana is not an uncommon cause of native valve endocarditis in children in Ethiopia with heart defects and that possible B. quintana infection should be suspected and pursued among residents of and immigrants from East Africa, including Ethiopia, with culture-negative endocarditis. (cdc.gov)
  • Some of the common mechanisms by which heart sounds are generated include (1) opening or closure of the heart valves, (2) flow of blood through the valve orifice, (3) flow of blood into the ventricular chambers, and (4) rubbing of cardiac surfaces. (medscape.com)
  • The heart sounds transmitted are due to closing of heart valves, and abnormal heart sounds, called murmurs, usually represent valve incompetency or abnormalities. (medscape.com)
  • This blood is pumped down to the right ventricle via the tricuspid valve and eventually through the pulmonic valve, leading to the pulmonary trunk that takes the oxygen deprived blood to the lungs for gas exchange. (medscape.com)
  • It is easy to detect because sounds of aortic and pulmonary valve closure are high-pitched and can be separated. (nursingjobsexam.com)
  • 1. The closure of pulmonary valve always follows the closure of aortic valve (aortic valve closes first). (nursingjobsexam.com)
  • When pulmonary valve closes earlier to aortic valve closure, the condition is called reverse splitting. (nursingjobsexam.com)
Apex5
  • This will decrease the distance from wall of the chest to the apex of the heart. (wikipedia.org)
  • The main anatomic areas to focus on while initially evaluating heart sounds include the cardiac apex, the aortic area (second intercostal space [ICS] just to the right of the sternum or the third ICS just to the left of sternum), the pulmonary area (second ICS just to the left of sternum) and the tricuspid area (fourth and fifth ICS just to the left of sternum). (medscape.com)
  • The normal heart sound demonstrating S1 followed by an S2, best audible at the apex. (medscape.com)
  • M 1 is best heard over the apex of the heart, and T 1 is best heard over the fourth ICS at the left sternal border. (medscape.com)
  • It is heard best at the apex of the heart (apical area). (nursingjobsexam.com)
Pathologic2
  • Characteristics of pathologic murmurs include a sound level of grade 3 or louder, a diastolic murmur or an increase in intensity when the patient is standing. (aafp.org)
  • Busy clinicians need an approach that allows them to appropriately identify and refer patients with pathologic murmurs to a pediatric cardiologist. (aafp.org)
Edema2
  • Coughing from acute pulmonary edema is usually less than a few days duration and progresses rapidly in severity. (vin.com)
  • Cats appear not to cough, even when severe pulmonary edema is present. (vin.com)
Veins2
  • The cardiovascular system consists of the heart, which is an anatomical pump, with its intricate conduits (arteries, veins, and capillaries) that traverse the whole human body carrying blood. (medscape.com)
  • Arteries are blood vessels that transport blood away from the heart, and veins transport the blood back to the heart. (medscape.com)
Diastolic1
  • Timing refers to whether the murmur is a systolic, diastolic, or continuous murmur. (wikipedia.org)
Valves7
  • The first heart sound (S 1 ) is produced by vibrations generated by closure of the mitral (M 1 ) and tricuspid valves (T 1 ). (medscape.com)
  • In these cases, the Cardiologist will need to perform tests to evaluate the functioning of the heart and the heart valves. (bluenethospitals.com)
  • Blood flows through the heart in only one direction enforced by a valvular system that regulates opening and closure of valves based on pressure gradients (see image below). (medscape.com)
  • Heart sounds are generated by blood flowing in and out of the heart's chambers through the valves as they open and close. (nursingjobsexam.com)
  • Closure of the mitral and tricuspid valves creates the first heart sound (S1). (nursingjobsexam.com)
  • Closing of the aortic and pulmonic valves produces the second heart sound (S2). (nursingjobsexam.com)
  • The splitting of the second heart sound is due to the separation between the closure of aortic and pulmonary valves. (nursingjobsexam.com)
Venous return1
  • The pumping action of the heart usually maintains a balance between cardiac output and venous return. (medscape.com)
Auscultation4
  • Auscultation of a cardiac murmur can indicate underlying structural cardiac disease or a physiologic change (eg, elevated cardiac output). (merckvetmanual.com)
  • Auscultation of the heart forms the core of cardiac physical examination. (medscape.com)
  • [ 1 ] In addition, auscultation of the left axilla, base of the heart, carotid arteries, and interscapular area should be performed to assess for radiation of heart sounds and murmurs. (medscape.com)
  • The first indication of heart disease may be the discovery of an abnormal sound on auscultation. (nursingjobsexam.com)
Abnormal heart sounds1
Contraction1
Turbulent blood flow1
  • A heart murmur is generated by turbulent blood flow that can be auscultated with a stethoscope. (merckvetmanual.com)
Diagnosis2
  • The history solicits information intended to: 1) distinguish between cardiac and pulmonary disease, 2) establish a diagnosis, 3) determine the frequency and extent of clinical impairment, 4) assess response (or lack of response) to therapy, 5) detect other medical conditions, and 6) establish a doctor-client relationship. (vin.com)
  • At BlueNetHospitals , we have a highly trained medical team specialized in Cardiology and heart care, committed to providing a comprehensive approach to the diagnosis, treatment, and management of heart murmurs. (bluenethospitals.com)
Live births1
  • Overview of Congenital Cardiovascular Anomalies Congenital heart disease is the most common congenital anomaly, occurring in almost 1% of live births ( 1). (merckmanuals.com)
Physiologic1
Congenital heart d2
  • It is usually an isolated lesion and occurs in up to 12% of congenital heart disease (CHD). (medscape.com)
  • Among birth defects, congenital heart disease is the leading cause of infant mortality. (merckmanuals.com)
Radiation1
  • Radiation refers to where the sound of the murmur travels. (wikipedia.org)
Coughing1
  • Chronic pulmonary congestion may cause mild intermittent coughing and nocturnal dyspnea or cough. (vin.com)
Defects2
  • Murmurs are of various types and are important in the detection of cardiac and valvular pathologies (i.e. can be a sign of heart diseases or defects). (wikipedia.org)
  • Heart murmur -- The presence of a murmur can be an indication of cardiomyopathy, congenital defects and more. (intrapet.com)
Echocardiography4
  • Echocardiography is not always needed to diagnose pediatric murmurs. (aafp.org)
  • One study 3 showed that direct referral for echocardiography was an expensive way to evaluate children with heart murmurs. (aafp.org)
  • Pediatric cardiology consultation was significantly less costly in that many innocent murmurs were diagnosed without echocardiography. (aafp.org)
  • Echocardiography is an ultrasound modality that uses sound waves to create images that assess heart function. (bluenethospitals.com)
Infants4
  • Infants and children with ejection murmurs auscultated in the pulmonic region often undergo evaluation and PVS may be uncovered. (medscape.com)
  • Most infants have a murmur, the nature of which depends on the presence of associated anomalies. (merckmanuals.com)
  • Infants with decreased pulmonary blood flow usually have mild-to-moderate cyanosis at birth, which increases, sometimes dramatically, over the first several months of life. (merckmanuals.com)
  • Infants with increased pulmonary blood flow usually show signs of heart failure (eg, tachypnea, dyspnea with feeding, poor weight gain, diaphoresis) by age 4 to 6 weeks. (merckmanuals.com)
Abnormalities1
Occurs1
Exam1
  • A murmur is a sign found during the cardiac exam. (wikipedia.org)
Increase in intensity1
  • Crescendo murmurs increase in intensity over time. (wikipedia.org)
Cardiac cycle2
  • While interpreting the heart sounds, it is essential to understand from which part of the cardiac cycle they are being generated. (medscape.com)
  • A normal heart rate is approximately 72 beats/minute, and the cardiac cycle spreads over 0.8 seconds. (medscape.com)
Characteristics3
Rheumatic heart d1
  • By 2005, the total number of cardiovascular disease (CVD) deaths (mainly coronary heart disease, stroke, and rheumatic heart disease) had increased globally to 17.5 million from 14.4 million in 1990. (health.am)
Intensity3
  • Decrescendo murmurs decrease in intensity over time. (wikipedia.org)
  • Intensity refers to the loudness of the murmur with grades according to the Levine scale, from 1 to 6: Pitch may be low, medium or high. (wikipedia.org)
  • As detailed in the specific cardiac disease sections that follow, the location, timing, and intensity of a heart murmur may correlate with a specific type of cardiac disease or the severity of the disease. (merckvetmanual.com)
Decrescendo3
  • Murmurs can be crescendo, decrescendo or crescendo-decrescendo. (wikipedia.org)
  • Crescendo-decrescendo murmurs have both shapes over time. (wikipedia.org)
  • Crescendo-decrescendo murmurs resemble a diamond or kite shape. (wikipedia.org)
Disease10
  • Many normal children have heart murmurs, but most children do not have heart disease. (aafp.org)
  • An appropriate history and a properly conducted physical examination can identify children at increased risk for significant heart disease. (aafp.org)
  • 1 Most of these young patients do not have heart disease. (aafp.org)
  • However, this examination must be performed on any child who has a heart murmur or historical features that indicate the presence of heart disease or abnormal cardiac function. (aafp.org)
  • Congenital heart disorders may be implied if siblings, dam or sire have been effected with known cardiovascular disease. (vin.com)
  • expiratory dyspnea suggests lower airway obstruction, parenchymal lung disease, heart failure, chronic obstructive lung disease, and other conditions. (vin.com)
  • Some heart murmurs are harmless, meaning they do not indicate a heart disease and do not require treatment. (bluenethospitals.com)
  • On the other hand, some heart murmurs can be signs of a serious heart disease. (bluenethospitals.com)
  • Of these, 7.6 million were attributed to coronary heart disease and 5.7 million to stroke. (health.am)
  • 5g/dl of deoxygenated Hb and if the cyanosis is present centrally may suggest chest disease or a cyanotic heart condition. (abcmedicalnotes.com)
Turbulence2
  • The conditions under which turbulence will occur (ie, development of a murmur) can be described by the Reynold's number , which is calculated: Re = (mean velocity of blood flow x vessel diameter x blood density) / blood viscosity. (merckvetmanual.com)
  • When a critical Reynold's number is exceeded, turbulence and a resultant murmur will occur. (merckvetmanual.com)
Systemic2
  • the left side chambers supply the systemic circulation, and the right side chambers supply the pulmonary circulation. (medscape.com)
  • Systemic and pulmonary circulation. (medscape.com)
Cardiology1
  • The focus is on helping physicians become even more confident about their ability to diagnose innocent murmurs and to decide which patients might benefit from pediatric cardiology referral. (aafp.org)
Blood flows1
Orifice1
  • These tubercles develop around the orifice of the pulmonary tree. (medscape.com)
Innocent3
  • An innocent systolic flow murmur is audible, as well as the normal splitting of S2 on inspiration. (wikipedia.org)
  • Nonetheless, 61 percent of the murmurs referred for subspecialist evaluation were found to be functional, or innocent, murmurs. (aafp.org)
  • The investigators hypothesized that increased education of health care providers and parents might be helpful in alleviating unnecessary anxiety and reducing the number of patients with innocent murmurs who are referred for further evaluation. (aafp.org)
Trunk1
Symptoms1
  • It is important to note that specific symptoms may vary depending on the underlying cause of the heart murmur. (bluenethospitals.com)