Cardiac Examination Auscultation of the Heart

AuscultationHow to take good medical history & examination. Read more ... » of the HeartECG General description with Basic idea of 12 Leads with Positions On Body. Read more ... »

In CardiacGrave's disease Causes and Treatment. Read more ... » ExaminationHow to take good medical history & examination. Read more ... » Auscultation is the most important part of examination, which provides us the most of the information about Heart condition, Functioning and many more..

• The first heart sound S1 is produced by the mitral and tricuspid valve closure.
• The second heart sound S2 is produced by the closure of the aortic and pulmonary valves.
• A2 or aortic closure sound comes earlier than P₂ or pulmonary closure sound.
• During inspiration the split between A₂ and P₂ is in­creased and during expiration the split between A₂ and P₂ is decreased.
• An ejection sound may be heard after S1, in cases of pulmonary hypertensionDiabetes mellitus Types,Causes,Symptoms and Diagnosis. Read more ... », systemic hypertension, dilatation of Pulmonary artery or aorta.
• A pericardial knock may be heard after S2 in cases of pericardial diseaseAyurveda Drugs MANDUKPARNI CENTELLA ASCIATICA Specifically work on the Central Nervous System. Read more ... ».

CausesAyurveda Drugs MANDUKPARNI CENTELLA ASCIATICA Specifically work on the Central Nervous System. Read more ... » of loud first sound

• MS
• Tachycardia
• Hyperdynamic circulation – feverThyrotoxic crisis or Thyroid storm. Read more ... », thyrotoxicosis, ex­ercise, AR, PDAPatent Ductus Arteriosus (PDA) Clinical features Diagnosis with Treatment. Read more ... »
• Short PR interval

Causes of loud second sound (S2,)

• Loud A₂ – is found in systemic hypertension, dilata­tion of the ascending aorta as in rheumatic feverRheumatic Fever Causes of Rheumatic fever Diagnosis Rheumatic fever TREATMENT. Read more ... » and syphilis.
• Loud P₂ – is found in pulmonary hypertension, cor­pulmonale, ASDEisenmenger syndrome (ASD, VSD, PDA With PAH with reversal of shunt - Right-to-Ieft shunt) with Treatment. Read more ... », VSDEisenmenger syndrome (ASD, VSD, PDA With PAH with reversal of shunt - Right-to-Ieft shunt) with Treatment. Read more ... », PDA.

Causes when split between A₂ and P2 is increased –

• ASD
• Pulmonary stenosis
• RBBB
• MR
• VSD
• Pulmonary hypertension
• Idiopathic dilatation of pulmonary artery WPW syndromeMetabolic,Insulin Resistance Syndrome X Causes Symptoms. Read more ... »
• LV ectopics
• RV failure

Causes of single second heart sound (S2)

• Tetralogy of FallotCYANOTIC CONGENITAL HEART DISEASE (Tetralogy of Fallot, Truncus arteriosus ). Read more ... »
• Severe PS
• AS
• LBBB
• Truncus arteriosusCYANOTIC CONGENITAL HEART DISEASE (Tetralogy of Fallot, Truncus arteriosus ). Read more ... » Tricuspid atresia

Causes of reversed (paradoxical) splitting of the second heart sound (S2)

• LBBB
• AS·
• PDA
• Hypertension
• WPW syndrome

Causes of S3 or ventricular or diastolic gallop

• LVF and LV dysfunction
• Cardiomyopathies

Causes of S4 or atrial gallop

• Aortic stenosisAortic Stenosis Symptoms Aortic Stenosis Physical Findings Auscultation TREATMENT. Read more ... »
• AR
• Elderly persons Hypertension
• CardiomyopathyCardiomyopathy Clinical features Etiology Diagnosis Dilated Hypertrophic Restrictive cardiomyopathy with Treatment. Read more ... »

Causes of pericardial knock

• Constrictive pericarditisCHRONIC CONSTRICTIVE PERICARDITIS Physical findings and Treatment. Read more ... »
• Pericardial effusion

Cardiac Murmurs

Systolic murmurs at the apex may be due to :

• · Mitral regurgitation
• · Papillary muscle dysfunction
• · Cardiomyopathy
• · Aortic stenosis ejection systolic murmur

Diastolic murmurs at the apex may be due to:

• · Mitral stenosis (diastolic thrill is usually present)
• · Mitral flow murmur in MR
• · Austin Flint murmur in AR
• · Carey Coombs murmur in rheumatic carditis

Systolic murmurs in parasternal area may be due to-:–

• · Aortic stenosis – ejection systolic murmur, in­creasing on expiration, radiating to carotids
• · Tricuspid regurgitationTricuspid Stenosis and Tricuspid Regurgitation Symptoms Investigations and Treatment. Read more ... » (increasing in inspiration and best heard at the lower e ge of sternumf
• · Pulmonary hypertension – ejection systolic mur­mur
• · Ventricular septal defectVentricular Septal Defect (VSD) CLINICAL FEATURES and examination Investigations with Treatment. Read more ... » (VSD) – Pansystolic murmur
• · Pulmonary stenosis (left second intercostal space) – ejection systolic murmur

Diastolic murmurs in parasternal area may be due to: -

• Aortic regurgitationAortic Regurgitation Symptoms of Aortic Regurgitation Aortic Regurgitation TREATMENT. Read more ... »
• Tricuspid stenosisTricuspid Stenosis and Tricuspid Regurgitation Symptoms Investigations and Treatment. Read more ... »
• Graham Steell murmur of pulmonary regurgita­tion
• for more information
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