: Admin : 2022-01-29
What are heart sounds?
Heart sounds are generated by blood flowing in and out of the heart’s chambers through the valves as they open and close. Heart sounds are noises produced by a beating heart and the resulting blood flow. Specifically, the sound reflects the turbulence that occurs when the heart valves close. ... the first heart sound, or S1, forms the "club" of the "lablab" and is made up of components M1 (mitral valve occlusion) and T1 (tricuspid valve closure).
How does the heart work?
The heart is a muscular organ and has four chambers that receive and pump blood.
The left ventricle pumps oxygen-enriched blood to the rest of the body through a network of arteries. The right atrium receives oxygen-depleted blood from the body through a vein and pumps it to the right ventricle. The right ventricle pumps blood into the lungs for oxygenation.
Contraction of the left ventricle while pumping blood creates systolic blood pressure in the arteries (higher readings in blood pressure readings). A web of nervous tissue travels through the heart, sending an electrical signal to the heart muscle to initiate a heart contraction. The heart valves allow blood to move in only one direction, opening and closing as the heart pumps blood.
Four heart valves:
What makes the heart sound?
Blood flow creates vibrations in the ventricles and valves, producing audible sounds that can be heard through a stethoscope. Smooth blood flow with low resistance is called laminar flow. If the flow is rough and has high resistance, it is said to be turbulent.
oscillations increase with turbulence in the bloodstream and some functions of the heart that produce heart sounds are The heart's ventricles, Friction on the surface of the heart.
What are the four heart sounds?
First Sound
When both ventricles contract, pushing blood into the aorta and pulmonary arteries, the mitral and tricuspid valves close to prevent backflow of blood into the atria. The first sound S1 is produced by the vibrations generated when these two valves close.
Normally, the mitral valve closes just before the tricuspid valve, and when two different sounds are detected, it is called "S1 splitting". S1 isolation may indicate certain conditions affecting the heart.
Second Sound
After pumping blood, the ventricles relax to receive blood from the atria and the diastolic phase begins. The aortic and pulmonary valves close and vibrate to produce a second heart sound, S2. An increase in the intensity of this sound may indicate certain conditions.
S2 segmentation can occur when the aortic valve closes just in front of the pulmonary valve. This may indicate a violation of heart function.
Third sound
The third heart sound (S3), also known as “ventricular sprint,” occurring 120 to 180 milliseconds after the second heart sound (S2), is a series of low-frequency oscillations of early diastole that is the best heard with a stethoscope. heart bell. Top. The third heart sound is mainly produced by the rapid diastolic dilatation of the left ventricle, which is accompanied by rapid filling of the ventricles and a sharp slowing of atrioventricular blood flow. The third heart sound in children and adolescents is normal but usually disappears after the age of 40. A third heart sound also occurs in patients with high cardiac output due to anaemia, fever, pregnancy, and thyrotoxicosis. If the patient is over 40, a third heart sound almost always indicates a problem. Usually left ventricular failure or left ventricular failure with low ejection fraction, limited diastolic filling, but less often mitral regurgitation or stenotic pericarditis.
Fourth sound
The fourth is a low-intensity sound heard just before S1 in the cardiac cycle. The fourth heart sound is a low tone consistent with late diastolic ventricular filling due to atrial contraction. Therefore, it occurs just before the first heartbeat. Also called atrial sound, it requires efficient atrial contraction to produce it, but the fourth heart sound is the result of vibrations occurring within the ventricles. Its presence usually indicates increased resistance to left or right ventricular filling due to a decrease in ventricular wall compliance and is accompanied by an unbalanced increase in ventricular end-diastolic pressure. Patients with a fourth heart sound often have a palpable correlation.
The cardiac cycle has two phases systolic & diastolic.
Diastole vs Systole
Now that we have a good understanding of the anatomy and blood flow of the heart, let’s discuss the cardiac cycle.
There are 2 main phases to the heart cycle - diastole and systole.
The diastolic phase is defined as the phase in which the heart, particularly the ventricles, is at rest. A relaxed heart allows blood to fill the atria.
Systolic is defined as the phase in which the heart, especially the ventricles, contracts. Constriction causes blood to flow into the pulmonary circulation and systemic vasculature through the main pulmonary artery and aorta, respectively.
Diastolic: This is the stage in which the heart, especially the ventricles, is at rest and the atria fill with blood.
Systole: The phase in which the heart, especially the ventricles, are contracting and pushing blood forward into the pulm.
Diastole: The phase in which the heart, especially the ventricles, is at rest allowing the cardiac chambers to fill with blood.
These two steps constitute a heartbeat.
The heart of a healthy adult produces two sounds, commonly described as "lab" and "oral".
Murmurs
Most nurses associate heart murmurs with heart valve abnormalities. However, there are many other conditions that can cause noise. The murmur can also be caused by blood flow through a narrowed or irregular valve or directly into an enlarged heart cavity or blood vessel. It can also be caused by a valve disorder or reflux of blood through a septal defect. The noise is usually described as a "running" or "whistling" sound. The murmur is usually associated with a valve defect, ventricular septal defect, or atrial septal defect. While auscultating a murmur, the nurse should record the time, nature, location, and spread of the noise. Characteristics include volume, intensity, pitch, and noise quality. These evaluation factors are discussed in more detail later in the course.
Gallop
Stethoscope Bell can be used for low-frequency sounds (better amplified with a bell). Gallops S3 and S4 are usually low-pitched and are best heard with a bell on a stethoscope with the patient extended to the left. Many nurses choose to repeatedly auscultate heart sounds with the bell tube of a stethoscope to detect sounds that may be missed by the diaphragm. Gallop S3, ventricular gallop occurs at the end of the ventricular systolic. Often caused by premature blood rushing into the ventricles, stiff or dilated ventricles due to heart failure, coronary artery disease, or pulmonary hypertension.
Click
A "click" is an additional sound often heard in patients with mitral valve prolapse, aortic stenosis, or prosthetic heart valves. A "click" when the opening is usually caused by a mitral or tricuspid stenosis.
Friction Noise
Friction noise, also called friction noise, occurs during the friction of the visceral and parietal layers of the pericardium. The sound is produced when there is inflammation due to uremic pericarditis, myocardial infarction, or other inflammatory conditions.
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