Heart sound: Difference between revisions

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In medicine, heart sounds are the "sounds heard over the cardiac region produced by the functioning of the heart. There are four distinct sounds: the first occurs at the beginning of systole and is heard as a "lubb" sound; the second is produced by the closing of the aortic valve and pulmonary valve and is heard as a "dupp" sound; the third is produced by vibrations of the ventricular walls when suddenly distended by the rush of blood from the heart atria; and the fourth is produced by atrial contraction and ventricular filling."<ref>{{MeSH}}</ref>
In [[medicine]], '''heart sounds''' are the "sounds heard over the cardiac region produced by the functioning of the heart. There are four distinct sounds: the first occurs at the beginning of systole and is heard as a "lubb" sound; the second is produced by the closing of the aortic valve and pulmonary valve and is heard as a "dupp" sound; the third is produced by vibrations of the ventricular walls when suddenly distended by the rush of blood from the heart atria; and the fourth is produced by atrial contraction and ventricular filling."<ref>{{MeSH}}</ref>
 
==Normal heart sounds==
[[Image:Gray-image1218.gif|right|thumb|350px|{{#ifexist:Template:Gray-image1218.gif/credit|{{Gray-image1218.gif/credit}}<br/>|}}The location of the heart below the thoracic wall.]]
===S<sub>1</sub>===
S<sub>1</sub>, which originates from closure of the mitral and tricuspid valves is normally louder than S<sub>2</sub> at the cardiac apex (fifth left intercostal space).<ref name="isbn1-4160-2898-6_p418">{{cite book |author=McGee, Steven R. |authorlink= |editor= |others= |title=Evidence-Based Physical Diagnosis: Text with BONUS PocketConsult Handheld Software |edition= |language= |publisher=Saunders |location=Philadelphia |year=2007 |origyear= |pages=418 |quote= |isbn=1-4160-2898-6 |oclc= |doi= |url= |accessdate=}}</ref>
 
===S<sub>2</sub>===
S<sub>2</sub> is normally louder than S<sub>1</sub> at the cardiac base (second left intercostal space).<ref name="isbn1-4160-2898-6_p415">{{cite book |author=McGee, Steven R. |authorlink= |editor= |others= |title=Evidence-Based Physical Diagnosis: Text with BONUS PocketConsult Handheld Software |edition= |language= |publisher=Saunders |location=Philadelphia |year=2007 |origyear= |pages=415 |quote= |isbn=1-4160-2898-6 |oclc= |doi= |url= |accessdate=}}</ref>
 
The S<sub>2</sub> is composed of A<sub>2</sub> and P<sub>2</sub>:
* A<sub>2</sub> originates from closure of the aortic valve
* P<sub>2</sub> originates from closure of the pulmonic valve, is best heard at the cardiac base (second left intercostal space), and is quieter than A<sub>2</sub>.
** During expiration, A<sub>2</sub> and P<sub>2</sub> are perceived as a single sound in 90% of people.<ref name="isbn1-4160-2898-6_p422">{{cite book |author=McGee, Steven R. |authorlink= |editor= |others= |title=Evidence-Based Physical Diagnosis: Text with BONUS PocketConsult Handheld Software |edition= |language= |publisher=Saunders |location=Philadelphia |year=2007 |origyear= |pages=422 |quote= |isbn=1-4160-2898-6 |oclc= |doi= |url= |accessdate=}}</ref><ref name="pmid5718983">{{cite journal |author=Harris A, Sutton G |title=Second heart sound in normal subjects |journal=British heart journal |volume=30 |issue=6 |pages=739–42 |year=1968 |month=November |pmid=5718983 |pmc=487796 |doi= |url=http://heart.bmj.com/cgi/pmidlookup?view=long&pmid=5718983 |issn=}} [http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=citizendium&pubmedid=5718983 PubMed Central]</ref>
** During inspiration, the interval between A<sub>2</sub> and P<sub>2</sub> lengthens ('splits') and may as long as 60 msecs.<ref name="pmid5718983"/>


==References==
==References==
<references/>
<references/>
==Bibliography==
* {{cite book |author=McGee, Steven R. |authorlink= |editor= |others= |title=Evidence-Based Physical Diagnosis: Text with BONUS PocketConsult Handheld Software |edition= |language= |publisher=Saunders |location=Philadelphia |year=2007 |origyear= |pages= |quote= |isbn=1-4160-2898-6 |oclc= |doi= |url= |accessdate=}}
* {{cite book |author=Drummond Rennie; David Simel |authorlink= |editor= |others= |title=THE RATIONAL CLINICAL EXAMINATION: EVIDENCE-BASED CLINICAL DIAGNOSIS (Jama & Archives Journals) |edition= |language= |publisher=McGraw-Hill Professional |location= |year=2008 |origyear= |pages= |quote= |isbn=0-07-159030-7 |oclc= |doi= |url= |accessdate=}}
==See also==
* [[Heart murmur]]

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In medicine, heart sounds are the "sounds heard over the cardiac region produced by the functioning of the heart. There are four distinct sounds: the first occurs at the beginning of systole and is heard as a "lubb" sound; the second is produced by the closing of the aortic valve and pulmonary valve and is heard as a "dupp" sound; the third is produced by vibrations of the ventricular walls when suddenly distended by the rush of blood from the heart atria; and the fourth is produced by atrial contraction and ventricular filling."[1]

Normal heart sounds

The location of the heart below the thoracic wall.

S1

S1, which originates from closure of the mitral and tricuspid valves is normally louder than S2 at the cardiac apex (fifth left intercostal space).[2]

S2

S2 is normally louder than S1 at the cardiac base (second left intercostal space).[3]

The S2 is composed of A2 and P2:

  • A2 originates from closure of the aortic valve
  • P2 originates from closure of the pulmonic valve, is best heard at the cardiac base (second left intercostal space), and is quieter than A2.
    • During expiration, A2 and P2 are perceived as a single sound in 90% of people.[4][5]
    • During inspiration, the interval between A2 and P2 lengthens ('splits') and may as long as 60 msecs.[5]

References

  1. ↑ Anonymous (2024), Heart sound (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. ↑ McGee, Steven R. (2007). Evidence-Based Physical Diagnosis: Text with BONUS PocketConsult Handheld Software. Philadelphia: Saunders, 418. ISBN 1-4160-2898-6. 
  3. ↑ McGee, Steven R. (2007). Evidence-Based Physical Diagnosis: Text with BONUS PocketConsult Handheld Software. Philadelphia: Saunders, 415. ISBN 1-4160-2898-6. 
  4. ↑ McGee, Steven R. (2007). Evidence-Based Physical Diagnosis: Text with BONUS PocketConsult Handheld Software. Philadelphia: Saunders, 422. ISBN 1-4160-2898-6. 
  5. ↑ 5.0 5.1 Harris A, Sutton G (November 1968). "Second heart sound in normal subjects". British heart journal 30 (6): 739–42. PMID 5718983. PMC 487796. [e] PubMed Central

Bibliography

  • McGee, Steven R. (2007). Evidence-Based Physical Diagnosis: Text with BONUS PocketConsult Handheld Software. Philadelphia: Saunders. ISBN 1-4160-2898-6. 
  • Drummond Rennie; David Simel (2008). THE RATIONAL CLINICAL EXAMINATION: EVIDENCE-BASED CLINICAL DIAGNOSIS (Jama & Archives Journals). McGraw-Hill Professional. ISBN 0-07-159030-7. 

See also

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