Download Phonocardiogram

Phono Cardiogram
The Human Circulatory System
Systole (pronounced sis´to-le, rhymes with
"fiscally") is the contraction of heart chambers,
driving blood out of the chambers. The chamber
most often discussed is the left ventricle.
Diastole (pronounced di-as´to-le, rhymes with "potentially") is the
period of time when the heart relaxes after contraction.
Ventricular diastole is the period during which the ventricles
are relaxing, while atrial diastole is the period during which the
atria are relaxing
Heart Sounds
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S1 Sound
The S1 sound is normally the first heart sound
heard. See the diagram below for the location of
S1 during the cardiac cycle. The S1 is best heard
in the mitral area, and corresponds to closure of
the mitral and tricuspid (AV) valves. A normal
S1 is low-pitched and of longer duration than
S2.
S2 Sound
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The S2 sound is normally the second sound
heard. The S2 is best heard over the aortic area,
and corresponds to closure of the pulmonic and
aortic valves. A normal S2 is higher-pitched and
of shorter duration than S1.
The flow from the ventricles is more forceful
than the flow from the atria. Therefore, S2 will
normally be the louder sound.
Abnormal Heart Sounds
S3 Sound
The S3 sound is heard immediately following S2,
and is normal in children and adolescents, but
usually disappears after age 30. When heard in
adults, an S3 is called a “gallop” and indicates
left ventricular failure.
S4 Sound
The S4 sound is heard immediately before the S1,
and may be present in infants and children. The
S4 is produced with decreased compliance of the
ventricle and may indicate myocardial infarction
or shock.
Regurgitation and Stenosis
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Regurgitation is blood flow in the opposite
direction from normal, as the backward flowing
of blood into the heart or between heart
chambers.
stenosis(narrowing) is an abnormal narrowing
in a blood vessel.
Anomalies
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Mitral regurgitation (MR), a valvular heart disease also known
as mitral insufficiency, is the abnormal leaking of blood
through the mitral valve, from the left ventricle into the left
atrium of the heart
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Aortic insufficiency (AI), also known as aortic
regurgitation (AR), is the leaking of the aortic
valve of the heart that causes blood to flow in
the reverse direction during ventricular diastole,
from the aorta into the left ventricle
Aortic valve stenosis (AS) is a valvular heart
disease caused by the incomplete opening of the
aortic valve
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Mitral stenosis is a valvular heart disease
characterized by the narrowing of the orifice of
the mitral valve of the heart
Pulmonary valve stenosis is a valvular heart disease in
which outflow of blood from the right ventricle of the
heart is obstructed at the level of the pulmonic valve.
This results in the reduction of flow of blood to the
lungs.
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Tricuspid insufficiency, a valvular heart
disease also called Tricuspid regurgitation,
refers to the failure of the heart's tricuspid valve
to close properly during systole. As a result, with
each heart beat, blood is pumped out from the
right side of the heart in the opposite direction to
normal
A ventricular septal defect (VSD) is a defect in
the ventricular septum, the wall dividing the left
and right ventricles of the heart
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Patent ductus arteriosus (PDA) is a congenital
heart defect wherein a child's ductus arteriosus
fails to close after birth.
Auscultation
Auscultation Points
Area
Abnormality
Location
Aortic
2nd ICS
R sternal border
Aortic Stenosis
S2 is loudest
here
Pulmonic
2nd ICS
L sternal border
Pulmonary
stenosis or
regurgitation
Tricuspid
L lower sternal
border
Tricuspid
stenosis
Mitral
5th ICS
Mitral stenosis
or
regurgitation
S1 is loudest
here
Stethoscope
is an acoustic device for
auscultation or listening to the
Heart, lung and stomach
sounds of an animal or human.
Also used to listen to intestines
and blood flow in arteries and
veins.
In combination with a
sphygmomanometer used to
measure blood pressure.
Ancient Stethoscopes
The first stethoscope was
invented in France in 1846
It looked nothing like the
stethoscope of today – far
from being soft and flexible.
It was made from wood and
resembled a bathroom
plunger.
Regular Stethoscopes
The stereo stethoscope was
developed by Rappaport & Sprague
in the 1940s.
Great strides made during the 1960s
and 1970s in improving the materials
used in acoustic stethoscopes.
It lead to more precise diagnoses,
lower prices and better comfort.
Bell mode - High Frequency neonate, paediatric
Diaphragm mode - low frequency adults
Dr. William Proctor Harvey is a “virtuoso” who could diagnose complex
heart conditions just by listening heartbeat of patient through stethoscope.
Top Manufacturers: WelchAllyn, Littman, Thinklab, etc
Modern Stethoscopes
1.Digital Stethoscopes
2.Vi scopes
Allows the Doctor not only to hear, but
also to see graphical waveform evaluate
heart sounds for effective Cardiac
Treatment
Detect heart anomalies like
Septal defects
Regurgitation
Stenosis
Murmurs
Allows the Doctor not only to hear,
but also to see and evaluate heart
sounds for effective Cardiac
Treatment
Early Detection of Chronic
Cardiac Conditions
Adjustable Volume levels to auscultate in noisy
environments
Triage Quality Improved at the point of Care
Stenosis
Heart murmurs