A Summary of Abnormal Heart Sounds and their Causes

A Summary of Abnormal Heart Sounds and their Causes

1. Systolic Murmurs:

• Functional tricuspid regurgitation (large P ventricle):

• Location: KLS V, VI at the sternal border

• Characteristics: Increased intensity on inspiration, decreased on expiration (Carvallo +)

• Aortic stenosis:

• Location: Base of the heart at KLS 2P

• Characteristics: Ejection murmur, diamond-shaped, beginning immediately after T1, rough, radiating along both carotid arteries.

• Mitral regurgitation:

• Location: Cardiac apex, throughout systole

• Characteristics: Radiates to the axilla or the sternal border, sometimes throughout the anterior chest, high-pitched, blowing, grade 3/6, fixed throughout systole, more pronounced on expiration.

• Mitral valve prolapse or papillary muscle dysfunction:

• Characteristics: Late systolic murmur.

• Acute mitral regurgitation:

• Characteristics: Early systolic murmur.

• Late systolic murmur:

• Cause: Rupture of chordae tendineae.

• Musical murmur:

• Cause: Mitral valve prolapse.

2. Diastolic Murmurs:

• Aortic regurgitation:

• Location: KLS 3T

• Characteristics: Decrescendo, high-frequency, beginning immediately after T2, radiating from the sternum to the apex, best heard with the diaphragm, louder when the patient leans forward, exhales fully, and holds their breath.

• Mitral stenosis:

• Location: Cardiac apex

• Characteristics: Mid-diastolic rumble accentuated pre-systolic, low-pitched, best heard with the bell, louder on expiration, separated from T2 by a click of valve opening, radiating to the left axilla or low sternal border when intense.

3. Other Sounds:

• Functional murmur:

• Characteristics: Intensity <= 3/6, no clinical manifestations, non-radiating.

Note: This is a general overview and a consultation with a specialist is necessary for accurate diagnosis.