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That can mean a heart murmur?

Semiology — the science of private signs of disease finds it impossible to diagnose without hearing and proper evaluation of a heart murmur.

Ear any person, including the doctor, are not able to perceive all the sounds. Hearing picks up signals in the range from 16 Hz to 20,000 Hz per second, with maximum sensitivity from 1000 to 4000. And heart murmur are in the range from 5 to 800 Hz. It turns out that the sounds coming from the working of the heart beyond the greatest sensitivity of human hearing.

However, auscultation remains the most accessible method for studies of the heart and blood vessels. The doctor need not only skill, but also constant practice. Without exercise, the acuity of perception is reduced even more.

The conditions in which the patient is listened

Listening to the rules should be:

  • in complete silence (sounds from the side are prevented);
  • the patient is not permitted to speak;
  • camera (endoscope) is applied to the skin of the patient (jacket only listen to in the movie);
  • auscultation of the patient may be standing, in a horizontal position, on the left side;
  • an experienced doctor will perform the test with squats and listen to the patient again.

It is believed that the threshold of perception of sound by a doctor decreases with fatigue in the elderly.

The colors over the heart

First of all, pay attention to the tones. It is established that the first tone (systolic) consists of 4 components:

  • atrial;
  • the muscle vibrations of the ventricles;
  • the heart valves between the Atria and ventricles;
  • vascular — from the walls of the large vessels (pulmonary artery and aorta).

The optimal point of listening at the apex of the heart.

The second tone coincides with the early phase of diastole and is caused by closure of the valves of the aorta and pulmonary artery. It is accentuated at elevated pressures in a large and small circle of blood circulation, has a ringing character under the seal of the aorta (hardening). Maximum audibility at the base of the heart in the second intercostal space.

Change the first tone in different diseases:

  • split — with the possible atrioventricular blockade, thyrotoxicosis, malnutrition, neurosis, depends on non-simultaneous shutting the valves;
  • a dull, quiet tone — hypertrophy of left ventricle, myocarditis, myocardial infarction, emphysema, obese people;
  • loud, banging — in the case of malformation of the left atrioventricular opening (stenosis), neurosis, anemia, high temperature, after physical activity, tachycardia.

Some diseases cause a third tone. The reason for this is ferosirovina opening of the mitral valve (mitral stenosis). Hypertension, aortic aneurysm, myocarditis, myocardial, infarctionthe third cause of myocardial (diastolic) tone. He makes heart rhythm like the gallop. Scientists believe it is a manifestation after 30 years, the sign of the functional inferiority of the ventricles.

The mechanism of formation of noise

Noises in the heart and large vessels can be compared in origin with the motion of the fluid in the pipe. From the flow velocity depends on the turbulence. "Vortex" starts when the speed of circulation of more than 72 cm/sec. In addition, the change of direction of blood flow may occur when the violation of smoothness in the surface of the vascular wall.

  • listening position;
  • special conditions for gain — for example, in organic mitral regurgitation is recommended to listen to the patient standing, to offer to do 12 sit-UPS and re-listen, lying at the maximum exhalation; for the diagnosis of mitral stenosis, it is important to hear diastolic murmur in the position on the left side;
  • the tone is gentle, whistling, howling, hissing, rough, resembling a squeak — these epithets of this famous cardiologists of the 19th-20th centuries, which in the differential diagnosis preferred to rely only on your hearing and experience;
  • the relationship with the systole and diastole.

Depending on the phases of contraction are usually distinguished heart murmurs:

  • presystolic (determined before the beginning of the systole);
  • systolic (while reducing);
  • diastolic.

As noises are formed at defects

Valvular heart disease (stenosis of the atrioventricular, aortic, pulmonary holes) or the diameter of the vessel to form a systolic murmur in the flow of blood through the narrowed passage.

In case of insufficiency of aortic or mitral valve the mechanism is the same as during the closing holes shriveled the valves do not close tightly remains narrowed the gap through which back flow is returned to the blood in the aortic disease in the left ventricle, with mitral regurgitation from the left ventricle into the atrium).

Constant pattern:

  • defects associated with stenosis, auscultated systolic murmur;
  • in case of insufficiency of the valves and holes — diastolic.

Read more about heart murmur non-congenital children can be read here.

Features noise under certain vices and diseases