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Heart Murmur
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First Heart Sounds
Second Heart Sounds
Extra Heart Sounds (S3 & S4)
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Diastolic Murmurs
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Congenital Abnormalities
Cardiac Conditions Assoc. with Sudden Death
Heart Sounds in Primary Care
Auscultation Repetition Training
Heart Sounds Guide
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High Blood Pressure in Children
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Congenital Abnormalities
Ebstein's Anomaly
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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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The recommended auscultation position for the stethoscope is the
Tricuspid
position. For this sound, use stethoscope's
Diaphragm
.
The recommended patient position is
Supine
Phonocardiogram
This waveform plots sound amplitude on the vertical axis against time on the horizontal axis.
Heart Animation
Lessons
Coarctation of the Aorta
Patent Ductus Arteriosus
Atrial Septal Defect
Ventricular Septal Defect
Tetralogy of Fallot
Ebstein's Anomaly
Practice Drill
Listening Tips
A synopsis of important sound features and timing for this abnormality.
S1:
Increased intensity. Possible splitting.
Systole:
Rectangular.
S2:
Possible splitting..
Diastole:
Opening snap followed by decrescendo-crescendo murmur.
CaseID
117
CourseID
29
CourseCaseOrder
6
ID
109