Oh My Valve!
2nd Right Intercostal Space
What is Aortic valve?
Shortness of breath
What is dyspnea?
This sound is associated with heart failure (Coronary artery disease). Heard with bell of stethoscope at apex of heart.
What is S4 (atrial gallop)?
Soft, blowing, swishing sound indicating blood flow turbulence in the carotid; normally NONE are present. Listen with bell of stethoscope to assess.
What is a bruit?
We prevent this when assessing the carotid artery in older adult by using gentle pressure.
What is bradycardia?
2nd Left Intercostal Space
What is Pulmonic valve?
Awaken client from sleep at night and occurs with heart failure. Client wake up to catch breath.
What is Paroxysmal nocturnal dyspnea (PND)?
This sound is associated with heart failure and volume overload and is always abnormal over age 35 years. Heard with bell of stethoscope at apex of heart.
What is S3 (ventricular gallop)?
What is a thrill?
A ruler is held vertically at the sternal angle when assessing this.
What is jugular vein?
Left lower Sternal Border
What is Tricuspid valve?
The need to assume a more upright position to breathe.
What is orthopnea?
This heart sound is barely audible, heard only in a quiet room and with difficulty.
What is grade 1 murmur?
This occurs with right ventricular hypertrophy. You feel a diffuse lifting impulse during systole at the left lower sternal border. Forceful thrusting of the ventricle.
What is a lift (heave)?
It is normal to see an increase in ventricular dysrhythmias in this population.
What is older adult?
5th Intercostal Space around the Midclavicular Line
What is Mitral valve?
Recumbency at night promotes fluid resorption and excretion; this occurs with heart failure in the person who is ambulatory during the day.
What is nocturia?
You hear this sound when the aortic and pulmonic valves closes. Loudest at the base of the heart.
What is S2 sound?
This is a gentle, blowing, swooshing sound that can be heard on the chest wall. Indicates valve defects.
What is a murmur?
You can check this by auscultating apical heartbeat while palpating the radial artery.
What is pulse deficit?
3rd Left Intercostal Space
What is Erb's point?
Sudden sharp and stabbing pain relieved often by sitting or leaning forward and worsens by lying down or with inspiration. Inflammation of the pericardium, the fibrous sac surrounding the heart.
What is pericarditis?
When both the pathologic S3 and S4 are present, a quadruple heart rhythm is heard. This is an emergency!
What is summation sound (S3+S4)?
This is high pitched and scratchy, like sandpaper being rubbed. Caused by inflammation of the pericardium. Listen at the diaphragm.
What is pericardial friction rub?
This assessment is done by palpating the 4th or 5th midclavicular intercostal space.
What is apical impulse?