Abnormalities of Heart Sounds
- Loud S1
- Soft S1
- Loud A2
- Loud P2
- Soft A2
- Splitting of S1
- Increased splitting of S2
- Fixed splitting of S2
- Reversed splitting of S2
- S3 (third heart sound)
- S4 (fourth heart sound)
- Summation gallop
- Opening snap
- Systolic ejection click
- Mid-systolic click
- Tumor plop
- Pericardial knock
- Metallic click
- Bell (low pitched) Diaphragm (high pitched)
- Mitral Tricuspid Pulmonary Aortic areas
- S1 (first heart sound)
- S2 – Splitting (A2, P2)
Precordium – Auscultation Murmurs
- Timing of murmur
- Systolic
- Diastolic
- Continuous
- Site of maximal intensity
- Loudness
- Grades I-VI - Thrill
- Pitch
- Radiation
- Dynamic
- Respiration
- Valsalva
- Squatting
| Systolic Murmurs; Emptying Phase | Diastolic Murmurs/Sounds; Filling Phase |
|---|---|
| AS = Aortic stenosis & PS = pulmonary stenosis | AR = Aortic regurgitation & PR = pulmonary regurgitation |
| MR = Mitral Regurgitation | MS = Mitral Stenosis |
| I = innocent murmur | S3 = third heart sound; |
| HCM = hypertrophic cardiomyopathy VSD = ventricular septal defect | PDA = patent ductus arteriosus (continuous murmur) |
Examination – Back
- Percuss and auscultate lung bases
- Left ventricular failure
- Pleural effusion
- Sacral pitting edema
- Right heart failure
