Cardiac Conditions Associated with Sudden Death

This category is a survey of both normal and abnormal sounds and heart murmurs encountered in primary care. This includes hypertrophic cardiomyopathy, severe aortic stenosis, arrhythmogenic Rv Dysplasia, mitral valve prolapsed, myocarditis, commotion cordis, and Ebstein’s anomaly The lesson starts with normal heart sounds and continues with extra heart sounds and murmurs.

Please use good quality headphones or earphones. Computer or phones speakers often fail to reproduce some heart sounds.

Hypertrophic cardiomyopathy is a plight in which a portion of the heart becomes thickened without an obvious cause.
Arrhythmogenic right ventricular dysplasia is a rare type of cardiomyopathy. It occurs if the cardiac muscle tissue in the right ventricle dies and is replaced with scar tissue.

Mitral valve prolapsed is a condition in which two valves agitate of the mitral valve do not close smoothly or evenly, but instead prolapsed upward into the left atrium.

Myocarditis is an inflammation of the myocardium which affect your heart muscle and your heart’s electrical system.

Commotion cordis is an often deadly separation of heart rhythm that occurs as a result of a blow to the area directly over the heart at a critical time during the cycle of a heartbeat.

Ebstein’s anomaly is a congenital heart defect in which the septal and posterior leaflets of the tricuspid valve are ectopic towards the apex of the right ventricle of the heart.

In medical practices, correct diagnosis and understanding of the cases are important. So, while doing auscultation hearing the sounds correctly and identifying the abnormalities in it is important. Having prior practice to the sound will be a plus point for you, as we can do better in things we are familiar with. So, this site will be a friend for you in gaining practice in auscultation and learning different cases regarding it. So, practice as much as you want and gain your self- confidence and help for your future practices. This site will always be a friend in need in case of learning about heart sounds.

Hypertrophic Cardiomyopathy

As the name indicates, hypertrophic cardiomyopathy is a condition in which there is hypertrophy/thickness of the cardiac walls. The hypertrophic heart walls lead to difficulty in performing normal heart functions. The heart can’t pump blood normally.

This disease rarely shows symptoms; hence the hypertrophic cardiomyopathy remains undiagnosed usually. In a small population of patients, hypertrophic cardiomyopathy shows symptoms like difficulty in breathing, angina, and arrhythmias.

Other symptoms may include fainting after strenuous or even light exercises, irregular heartbeats, and shortness of breath. This disease is caused by a gene mutation that does not allow the heart muscle to grow in standard thickness. A high-pitched, crescendo-decrescendo, mid-systolic murmur is heard at the left lower sternal border on auscultation.

Aortic Stenosis – Severe 2

Aortic stenosis is a condition in which there is an obstruction of blood flow across the aortic valve. Severe aortic stenosis is the condition in which the aortic valve undergoes stenosis. The leaflets of the valves become thick and hard to open. This transfers more workload to the heart to pump blood.

Daily life activities are limited in case of severe aortic stenosis. Patients become tired faster. Failure of aortic valve surgery can cause aortic stenosis. The calcium build-up also plays a significant role. Its symptoms include tiredness, dizziness, angina, and shortness of breath.

On auscultation, the diamond-shaped systolic murmur is heard.

Arrhythmogenic RV Dysplasia

Arrhythmogenic Right ventricular dysplasia is a rare cardiac pathology. It is the disease of heart muscles. It occurs as a result of the death of muscle tissue in the right ventricle. This dead muscle tissue is then replaced by scar tissue. This causes arrhythmias. Common symptoms are palpitations ( fast heartbeat, irregular heartbeat) and fainting after strenuous exercise.

Arrhythmogenic RV dysplasia is an inherited disorder. The most affected age group is teens and adults. It can lead to sudden cardiac arrest in people who do athletic sports.

On auscultation, irregular cardiac rhythm is observed. S3 and S4 may also be noticed.

Mitral Valve Prolapse (Click with Late Systolic Murmur)

Mitral valve prolapse occurs when two flaps of the mitral valve fail to close smoothly and bulge upwards into the left atrium. This condition is also known as click murmur syndrome (click with late systolic murmur). It is also called Barlow’s syndrome. In this condition, some amount of the blood is leaked backward through the valve (regurgitation). This causes a click with a late systolic murmur. This condition usually is symptomless.

A heart murmur is heard on routine physical examination when the practitioner is listening to the heart sounds with a stethoscope. Common symptoms include chest fatigue and rapid heartbeat.

Myocarditis

Myocarditis is a condition in which inflammation of the heart muscles occurs. It has a direct effect on the heart muscles and electrical conductivity of the heart, which leads to difficulty in performing heart function. It causes irregular or abnormal heart rhythms.

The leading cause of myocarditis is decreased body immunity and viral infections. The Coxsackievirus is majorly involved. High degree myocarditis can result in permanent damage to the heart walls and muscles, which leads to inadequate flow of blood. The treatment of myocarditis-related heart failure is using a ventricular assist device. The second treatment option is a heart transplant.

Commotio Cordis

 When low-degree chest wall impaction causes sudden death due to arrhythmia, this condition is called Commotio cardis. This is mostly seen in sportspeople who play projectile motion sports like hockey, baseball, and a lacrosse ball. This is a condition in which the heart suddenly stops working. The leading cause is the trauma to the chest wall due to some heavy object like a ball or some blow.

During this condition, extreme damage is caused to the left and right ventricle and mitral and tricuspid valves. Immediate treatment is doing defibrillation immediately. On auscultation, the systolic or late systolic murmur is heard. This condition should be treated immediately.

Ebstein’s Anomaly

Ebstein’s anomaly occurs due to the malformations of the right atrium and right ventricle. It disturbs the functions of these valves. This leads to the backflow of blood into the right atrium through the valve. It is a congenital heart defect. The efficacy of the heart is decreased. Heart enlargement and MI can lead to Ebstein’s anomaly.

Its symptoms include difficulty in breathing, tiredness, abnormal heart rhythms, snd cyanosis. Some significant complications like stroke, cardiac arrest, and MI may be encountered.

On auscultation, the first heart sound is widely split with a high-pitched tricuspid component. This occurs due to a delay in the closure of the elongated anterior tricuspid leaflet. The mitral feature may be low or absent in the presence of prolonged PR interval.