Adult Cases : Heart Auscultation Quiz
This series of cases provides the listener with diagnostic exercises to integrate history and physical with a detailed analysis of the heart sounds and arrive at a diagnosis. Many are congenital heart disease but are common diagnoses and also suitable for learning adult presentation of these conditions. The recordings are of good quality from live subjects. A methodical approach to listening is essential: focus on S1, then S2, then systole and finally diastole.
NOTE: You will need good quality earbuds or possibly head phones but the closer the sound to your eardrums the better. Do not use computer speakers. Do not increase the loudness too much or you will get distortion.
Your feedback is helpful, at teachingheartauscultation@gmail.com.
Adult Case 1
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22 year old male. Pre military assessment. Previously played hockey at school, now less active but no symptoms during occasional hikes or mowing lawns. Never any cardiovascular symptoms. Family history unremarkable. On examination mildly overweight, BMI 28, heart rate 70 and regular, BP 122/80. Heart action and pulses are normal. You listen to the chest in the usual locations. This recording is at the left upper sternal edge.
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Answers
1.1 S2 normally split and varies with respiration, wider with inspiration
1.2 No systolic murmur
1.3 No diastolic murmurConclusion:
Normal heart sounds. The widening of S2 splitting with inspiration and narrowing with expiration are noted. Note that only inspiration breath sounds are audible.
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Describe S2:
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Describe systole:
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Describe diastole:
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Replay | Ecouter
- Case 1: 22 year old male. Pre military assessment.
- Case 2: 20 year old female, having a routine assessment for work.
- Case 3: 50 year old woman, episode of possible rheumatic fever with rash and arthralgia when she was a teenager.
- Case 4: 40 year old male, works on a lobster fishing boat. Generally fit but noticed a bit more fatigue in the last year.
- Case 5: 26 year old male reviewed for police service. Very healthy.
- Case 6: 30 year old female. Referred for assessment of heart murmur, recently discovered.
- Case 7: 30 year old male referred with a murmur.