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Heart sound by p r choudhary

  1. 1.  Heart sound is produce by mechanical activities of the heart during each cardiac cycle.  Heart sound is produce by movement of – 1. Blood through the chambers of heart. 2. Contraction of Cardiac muscle. 3. Valves of the heart. 4. Turbulent blood flow. All these factor produce vibration & its produce heart sound .  Heart sound are heard by placing the stethoscope over the chest.(I & II only).  Heart sound recorded graphically.  Heart sound are four types.
  2. 2.  Cause : due to closure of Atrio ventricular valves.  Character :long, soft & low pitched ,resembles the word “LUBB”.  Duration : 0.10 -0.17 sec.  Frequency : 25-45 cycles/sec.  Occurs during cardiac cycle : Isometric contraction period & part of ejection period.  Relation with ECG :coincides with peak of “R” wave  No of vibration in phonocardiogram: 9 -13
  3. 3.  Cause : closure of semi lunar valves .  Character : short , sharp & high pitched. resembles the word “DUB”.  Duration : 0.10-0.14 sec.  Frequency: 50 cyc/sec.  Occurs during cardiac cycle: ProtoDiastole .  Relation with ECG: peak of “T” wave.  No of vibration in phonocardiogram : 4-6
  4. 4.  Cause : due to Rushing of blood in to ventricles.  Character : Low pitched .  Duration : 0.07 -0.10 Sec.  Frequency : 1-6 Sec.  Occurs during cardiac cycle : Rapid Filling phase.  Relation with ECG: betn T wave & P wave .  No of vibration in phonocardiogram :1-4
  5. 5.  Cause : due to contraction of Atrial muscle.  Character : inaudible sound  Duration : 0.02 -0.04 sec.  Frequency: 1-4 cyc/sec.  Occurs during cardiac cycle : Atrial systole  Relation with ECG: betn “P” wave & “Q” wave.  No of vibration in phonocardiogram: 1-2
  6. 6.  The first & second heart sound heard by using stethoscope placed on 4 area on the chest K/a auscultation area 1. Mitral area (Bicuspid Area): In the left 5th intercostal space , 10 cm away from mid clavicular line .(area of apex beat) - 1st heart sound heard.(closure of mitral valve)
  7. 7. 3. Pulmonary Area : on the left 2nd intercostal space close to sternum. - 2nd Heart sound heard (closure of pulmonary valve). 4. Aortic area : over the right 2nd intercostal space close to sternum. - 2nd Heart sound heard (closure of Aortic valve). 2. Tricuspid area : on the xiphoid process. - 1st heart sound heard.(closure of Tricuspid valve).
  8. 8. All four Heart sound is Recorded by use of Phonocardiogram
  9. 9.  Cardiac murmur is the abnormal heart sound .  It produce due to turbulent blood flow. - cause of turbulent blood flow: * valvular disease * septal defects * vascular defects  Valvular disease are two type 1. Stenosis. 2. Incompetence.
  10. 10.  Stenosis. - means narrowing of the heart valve. so blood flow are rapidly & turbulence  Incompetence : - means weakening of the valve of heart so it cannot close properly causes back flow of blood produce turbulence.(regurgitation)
  11. 11.  Cardiac murmur are three types : 1. Systolic murmur – causes – * Incompetence of A-V valve * Stenosis of semi lunar valve * Anemia * septal defect 2. Diastolic murmur – causes – * Stenosis of A-V valve * Incompetence of semi lunar valve. 3. Continuous murmur causes – * patent ductus arteriosus.
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Heart sound by p r choudhary

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