Heart Sounds and Blood Pressure PDF
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Summary
This document provides a detailed explanation of heart sounds (S1, S2, S3, and S4) and blood pressure, including their causes, associated conditions, and normal ranges. It delves into concepts like systolic and diastolic pressures, and the relationship with cardiac output and systemic vascular resistance.
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Norma Heart Sounds ○ S1 or “Lub” Caused by the closure of AV Valves (Mitral and Tricuspid) Loudest at Apex/Mitral Area (Midclavicular, 5th intercostal space) and marks the end of diastole and the beginning of s...
Norma Heart Sounds ○ S1 or “Lub” Caused by the closure of AV Valves (Mitral and Tricuspid) Loudest at Apex/Mitral Area (Midclavicular, 5th intercostal space) and marks the end of diastole and the beginning of systole. ○ S2 or “Dub” Caused by closure of Semilunar Valves (Aortic and Pulmonic) Loudest at the Base/Aortic Area (Right Sternal Border, 2nd intercostal space) and marks the end of systole and the beginning of diastole. S2 sounds can split on inspiration Wide, fixed splitting is caused by a Right Bundle Branch Block S2 is louder with a pulmonary embolism Abnormal Heart Sounds ○ S3 This is caused by a rush of blood into a dilatted ventricle. Occurs early in diastole and right after S2. Best heard at the Apex/Mitral area with the Bell. This is associated with heart failure and may occur with crackles. Ventricular Gallop, think “Kentucky” Other Causes: Pulmonary Hypertension or Cor Pulmonale Mitral, Aortic, or, Tricuspid insufficiency ○ S4 Caused by atrial contraction of blood into a noncompliant ventricle. This occurs right before S1 and is best heard at the Apex/Mitral area with the bell. Associated with Myocardial ischemia, infarction, hypertension, ventricular hypertrophy, and aortic stenosis. Atrial gallop, think “Tennessee” ○ Pericardial Friction Rub Due to pericarditis and is associated with pain on deep inspiration. May be positional. Blood Pressure and Pulse Pressure ○ Pulse pressure is the difference between systolic and diastolic pressures. Normal is 40-60mmHg ○ Systolic blood pressure is an indirect measurement of cardiac output and stroke volume. A decrease in systolic blood pressure with little change or an increase in diastolic pressure is narrowing pulse pressure. This is most often seen with severe hypovolemia or a severe drop in cardiac output. ○ D iastolic blood pressure is an indirect measurment of systemic vascular resistance (SVR) A decrease in diastolic pressure that widens pulse pressure may indicate vasodilation and/or a drop in SVR. This is commonly seen in septic shock. Diastolic pressure is typically 1/3rd of systolic Coronarie arteries are perfused during diastole.
