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CARDIOVASCULAR SYSTEM CARDIAC CYCLE HEART SOUNDS

CARDIOVASCULAR SYSTEM CARDIAC CYCLE HEART SOUNDS. LECTURE – 4 DR. ZAHOOR ALI SHAIKH. HEART SOUNDS. There are four heart sounds SI, S2, S3 & S4. Two heart sound are audible with stethoscope S1 & S2 (Lub - Dub).

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CARDIOVASCULAR SYSTEM CARDIAC CYCLE HEART SOUNDS

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  1. CARDIOVASCULAR SYSTEM CARDIAC CYCLEHEART SOUNDS LECTURE – 4 DR. ZAHOOR ALI SHAIKH

  2. HEART SOUNDS

  3. There are four heart sounds SI, S2, S3 & S4. • Two heart sound are audible with stethoscope S1 & S2 (Lub - Dub). • S3 & S4 are not audible with stethoscope Under normal conditions because they are low frequency sounds. • Ventricular Systole is between First and second Heart sound. • Ventricular diastole is between Second and First heart sounds.

  4. First heart sound (S1) • It is produced due to the closure of Atrioventricular valves (Mitral & Tricuspid) • It occurs at the beginning of the systole and sounds like LUB • Frequency:50-60 Hz • Time: 0.15 sec

  5. Second heart sound (S2) • It is produced due to the closure of Semilunar valves (Aortic & Pulmonary) • It occurs at the end of the systole and sounds like DUB • Frequency:80-90 Hz [ High pitch ] • Time: 0.12 sec • It is short and sharp

  6. HEART SOUNDS • Important • Sounds are caused by vibrations set within the wall of the ventricles and major arteries during valve closure . • Opening of the valve does not cause sound.

  7. Third heart sound (S3) • It occurs at the beginning of middle third of Diastole • Cause of third heart sound – Rush of blood from Atria to Ventricle during rapid filling phase of Cardiac Cycle. It causes vibration in the blood • Frequency:20-30 Htz • Time: 0.1 sec

  8. Fourth heart sound (S4)or Atrial Sound • It occurs at the last one third of Diastole (just before S1) • Cause of Fourth heart sound – Due to Atrial contraction which causes rapid flow of blood from Atria to Ventricle and vibration in the blood. • Frequency: < 20 Htz Note: • Third and Fourth heart sound are low pitched sounds therefore not audible normally with stethoscope • S3 may be heard in children and young adults but usually pathological in old age

  9. EVENTS 1 st Heart Sound 2 nd Heart Sound 3 rd Heart Sound 4 th Heart Sound HEART SOUNDS

  10. Aortic Area – 2nd right Intercostal space at the right sternal border Pulmonary Area – 2nd left Intercostal space at the left sternal border Mitral Area – 5th left Intercostal space 1cm inside mid – clavicular line [Apex beat area] Tricuspid Area – Left side of lower sternum

  11. Heart Murmurs • Murmurs are abnormal sounds produced due to abnormal flow of blood [turbulent blood flow] through abnormal heart valves e.g.. stenosis or incompetence. • Stenosis means narrow or stiff, valve that does not open completely. • Incompetent means valve which does not close properly and remains open.

  12. Heat Murmurs • When blood is forced through stenotic valve, it produces an abnormal whistling sound. • When blood flows backward through incompetent valve, it produces swishing or gurgling murmur sound. • Most common cause of stenosis and incompetent valve is Rheumatic fever, an auto immune disease triggered by Streptococcus bacterial infection.

  13. Heat Murmurs • Systolic murmur are produced during the systole of the ventricle, between 1st and 2nd heart sound (Lub – Murmer – Dup). • Diastolic murmur are produced during the diastole of the ventricle, between 2nd and 1st heart sound (Lub – Dup – Murmer – Lub). • During aortic stenosis and mitral incompetence – systolic murmur. • Aortic incompetence and Mitral Stenosis – diastolic murmur.

  14. We will discuss PRESSURE VOLUME LOOP 2. EVENTS OF CARDIAC CYCLE

  15. Relationship between Lt. ventricular volume & pressure changes

  16. Events of cardiac cycle for Lt. ventricular function showing changes in Lt. atrial pressure, Lt. ventricular pressure, aortic pressure, ventricular volume, ECG & phonocardiogram

  17. WHAT YOU SHOULD KNOW FROM THIS LECTURE? • Functions of A-V vales & Semilunar valves. • Functions of papillary muscles. • There are four heart sounds : S1, S2, S3, & S4. • Audible with stethoscope are only S1(Lub) & S2(Dub / Dup)

  18. Places to be auscultated on the chest for heart sounds i.e. Aortic, pulmonary, Mitral & tricuspid area. • Murmurs (abnormal heart sounds). • Pressure – Volume Low • Cardiac Cycle Diagram [Phases, Pressure, Volume, and Heart Sounds]

  19. THANK YOU

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