Complex Condition

This category will help you learn about complex conditions where heart murmurs are both in systole and diastole. It includes mitral regurgitation (severe), tricuspid regurgitation (severe), mitral stenosis, regurgitation of rheumatic origin, and acute pericarditis.

Before you take on this session you should have finished the normal heart sounds session, first heart sound, second heart sound sessions, extra heart sounds (S3 & S4), systolic murmur & diastole murmur. You should feel gratified with your ability to listen and be familiar with normal heart sounds.

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

Severe mitral regurgitation places an extra strain on the heart because, with blood pumping backward, there is less blood going forward with each beat. The pressure can climb into your right ventricle due to blood moving forward through the right ventricle and into the lungs in severe mitral regurgitation.

Acute pericarditis is a kind of pericarditis usually lasting less than 6 weeks. Pericarditis is the inflammation of the

pericardium (sac surrounding the heart). It is the most common condition affecting the pericardium.
In the medical practices, correct diagnosis and understanding of the case are important. So, while doing auscultation hearing the sounds correctly and identify the abnormalities in it are 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 you want and gain your self-confidence and help improve your future practices. This site will always be a friend in need in case of learning about heart sounds.

Mitral Regurgitation – Severe

Mitral regurgitation is the backward blood leakage through the mitral valve. 

See the mitral valve regurgitation animation. 

During contraction, a leaked mitral valve permits the flux of blood in two ways. 

A holosystolic (pansystolic) murmurs are the cardinal sign of mitral regurgitation and are better heard on the apex using the stethoscope diaphragm while the person is on the left side of the decubitus. 

The systolic murmur in mild MR can be abbreviated or can take place late in the systole.

Tricuspid Regurgitation – Severe

Tricuspid regeneration is not an inadequate closing condition of this valve. This problem allows blood to flood back into the top right chamber as the lower right (ventricle) chamber contracts.

The murmur of tricuspid regurgitation is identical to mitral. It is a large, holosystatic murmur, but better heard at the lower left of the sternum and radiates to the lower right sternal boundary.

Mitral Stenosis Severe and Regurgitation Mild – Rheumatic Origin

Aortic Stenosis Moderate and Regurgitation Mild – Rheumatic Origin

This is a case of mild aortic stenosis in a patient with rheumatism in combination with mild aortic regurgitation.

The first echo of the heart is normal.

The second tone of the heart is high pitched.

An aortic click is made in systematic, followed by a systolic murmur shaped like a diamond.

The first two-thirds of the diastole were occupied by a high-pitched degeneration murmur.

The aortic valve is mildly unstable and the ventricular left of the diastole is slightly rebounded by turbulent flows.

The chaotic flow of blood induces systemic and diastolic whispering.

Mitral Regurgitation and Aortic Regurgitation

The following is an example of aortic and mitral valves’ significant regurgitation.

Due to the minimum closing of the mitral valve leaflets, the first heart son is decreased minimally in early systole. The second sound of the heart is natural.

The rest of the systole is drawn from the rectangular murmur and the decrescendo murmur makes up much of the diastole. Both whisperings are moderately intense.

The mixture of the two whisperings gives a sound character back and forth.

The left atrium and the left ventricle are extended to the tab in anatomy.

The left ventricle (the systolic murmuring) is rejuvenating, chaotic, streaming from the aorta throughout the left ventricular flow (the diastolic whispering). The left flow is tumultuous. It is rejuvenated.

Acute Pericarditis

Acute pericarditis is an abruptly emerging, often painful, pericardial inflammation (flexible, two-layered sac enveloping the heart) that allows fibrin, red blood cells, and white blood cells to invade the pericardial area. It allows the fluid and blood components.

Murmurs are caused by incompetent or stenotic valves by turbulent blood flow. The rubbing together of two surfaces of the pericardial sack, by comparison, produces a pericardial pressure rub.

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