Auscultation Training by Repetition

Ebstein's Anomaly - C402, #117

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waveform of heart or lung sound
Listen for 2-3 minutes
maneuver
Supine
torso
Diaphragm

Listening Tips

S1: Increased intensity. Possible splitting.
Systole: Rectangular.
S2: Possible splitting..
Diastole: Opening snap followed by decrescendo-crescendo murmur.
Repetition Training - Intermediate Heart Sounds

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Lesson Text

This is an example of Ebstein's Anomaly as heard at the tricuspid area.

The first heart sound is increased due to thickening of the tricuspid valve leaflets.

The second heart sound is normal.

A rectangular murmur of tricuspid regurgitation fills all of systole.

An opening snap occurs 100 milliseconds into diastole followed by a decrescendo-crescendo murmur of mitral stenosis.

These findings are all a manifestation of downward displacement of the tricuspid valve into the right ventricle

In the anatomy tab you can see the enlarged right atrium and the small right ventricle. The upward plume from the right ventricle to the right atrium represents the systolic murmur.

The downward plume from the right atrium to the right ventricle represents the diastolic murmur.

This abnormality is congenital in nature.

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c402
CaseID117
CourseID29
CourseCaseOrder6
ID109