Cardiovascular system cardiac cycle heart sounds
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CARDIOVASCULAR SYSTEM CARDIAC CYCLE HEART SOUNDS. LECTURE – 4 DR. ZAHOOR ALI SHAIKH. HEART SOUNDS. There are four heart sounds SI, S2, S3 & S4. Two heart sound are audible with stethoscope S1 & S2 (Lub - Dub).

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CARDIOVASCULAR SYSTEM CARDIAC CYCLE HEART SOUNDS

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Cardiovascular system cardiac cycle heart sounds

CARDIOVASCULAR SYSTEM CARDIAC CYCLEHEART SOUNDS

LECTURE – 4

DR. ZAHOOR ALI SHAIKH


Heart sounds

HEART SOUNDS


Cardiovascular system cardiac cycle heart sounds

  • There are four heart sounds SI, S2, S3 & S4.

  • Two heart sound are audible with stethoscope S1 & S2 (Lub - Dub).

  • S3 & S4 are not audible with stethoscope Under normal conditions because they are low frequency sounds.

  • Ventricular Systole is between First and second Heart sound.

  • Ventricular diastole is between Second and First heart sounds.


First heart sound s1

First heart sound (S1)

  • It is produced due to the closure of Atrioventricular valves (Mitral & Tricuspid)

  • It occurs at the beginning of the systole and sounds like LUB

  • Frequency:50-60 Hz

  • Time: 0.15 sec


Second heart sound s2

Second heart sound (S2)

  • It is produced due to the closure of Semilunar valves (Aortic & Pulmonary)

  • It occurs at the end of the systole and sounds like DUB

  • Frequency:80-90 Hz [ High pitch ]

  • Time: 0.12 sec

  • It is short and sharp


Heart sounds1

HEART SOUNDS

  • Important

  • Sounds are caused by vibrations set within the wall of the ventricles and major arteries during valve closure .

  • Opening of the valve does not cause sound.


Third heart sound s3

Third heart sound (S3)

  • It occurs at the beginning of middle third of Diastole

  • Cause of third heart sound – Rush of blood from Atria to Ventricle during rapid filling phase of Cardiac Cycle. It causes vibration in the blood

  • Frequency:20-30 Htz

  • Time: 0.1 sec


Fourth heart sound s4 or atrial sound

Fourth heart sound (S4)or Atrial Sound

  • It occurs at the last one third of Diastole

    (just before S1)

  • Cause of Fourth heart sound – Due to Atrial contraction which causes rapid flow of blood from Atria to noncompliant Ventricle and vibration in the blood.

  • Frequency: < 20 Htz

    Note:

  • Third and Fourth heart sound are low pitched sounds therefore not audible normally with stethoscope

  • S3 may be heard in children and young adults but usually pathological in old age


Events

EVENTS

1 st Heart Sound

2 nd Heart Sound

3 rd Heart Sound

4 th Heart Sound

HEART SOUNDS


Heart murmurs

Heart Murmurs

  • Murmurs are abnormal sounds produced due to abnormal flow of blood [turbulent blood flow] through abnormal heart valves e.g.. stenosis or incompetence.

  • Stenosis means narrow or stiff, valve that does not open completely.

  • Incompetent means valve which does not close properly and remains open.


Heat murmurs

Heat Murmurs

  • When blood is forced through stenotic valve, it produces an abnormal whistling sound.

  • When blood flows backward through incompetent valve, it produces swishing or gurgling murmur sound.

  • Most common cause of stenosis and incompetent valve is Rheumatic fever, an auto immune disease triggered by Streptococcus bacterial infection.


Heat murmurs1

Heat Murmurs

  • Systolic murmur are produced during the systole of the ventricle, between 1st and 2nd heart sound (Lub – Murmer – Dup).

  • Diastolic murmur are produced during the diastole of the ventricle, between 2nd and 1st heart sound (Lub – Dup – Murmer – Lub).

  • During aortic stenosis and mitral incompetence – systolic murmur.

  • Aortic incompetence and Mitral Stenosis – diastolic murmur.


Cardiovascular system cardiac cycle heart sounds

We will discuss

PRESSURE VOLUME LOOP

2. EVENTS OF CARDIAC CYCLE


Relationship between lt ventricular volume pressure changes

Relationship between Lt. ventricular volume & pressure changes


Cardiovascular system cardiac cycle heart sounds

Events of cardiac cycle for Lt. ventricular function showing changes in Lt. atrial pressure, Lt. ventricular pressure, aortic pressure, ventricular volume, ECG & phonocardiogram


Thank you

THANK YOU


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