Cardiac Conditions Associated with Sudden Death

Aortic Stenosis - Severe 2 Sounds

In Severe Aortic Stenosis there is a diamond shaped systolic murmur which lasts throughout systole. The murmur is loud and higher pitched than the murmur of mild aortic stenosis. It is caused by calcification of the aortic valve leaflets.

There is a fourth heart sound heard in late diastole (just before the first heart sound). This is caused by the increased left ventricular wall thickness and stiffness.

S1 is normal. S2 is louder than normal. In fact, you are hearing only the accentuated pulmonic component of S2 due to heart failure on the left side.

The aortic ejection click heard in mild cases of valvular aortic stenosis is gone.

In the anatomy tab you can see the greatly thickened left ventricular wall and the almost totally immobile aortic leaflets.

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The recommended auscultation position for the stethoscope is the Aortic position. For this sound, use stethoscope's Diaphragm.

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The recommended patient position is Sitting

Phonocardiogram

This waveform plots sound amplitude on the vertical axis against time on the horizontal axis.

Heart Animation

Lessons

1	Hypertrophic Cardiomyopathy
2	Aortic Stenosis - Severe 2
3	Arrhythmogenic RV Dysplasia
4	Mitral Valve Prolapse (Click with Late Systolic Murmur)
5	Myocarditis
6	Commotio Cordis
7	Ebstein's Anomaly

Practice Drill

CaseID	90
CourseID	26
CourseCaseOrder	4
ID	78