Murmurs

Yep. You'll listen to somebody's chest. The cardiologist will ask you what the murmur is. You'll guess. You'll get it wrong. You'll feel bad. This won't really help you but at least if you say one of the following phrases, you won't feel like a complete tool. The four basic murmurs:

• Systolic
  • ejection systolic
  • pansystolic
• Diastolic
  • mid-diastolic
  • early diastolic

We'll get on those in a second. Firstly, we need to cover something more basic.

Normal sounds

They associate with the eight different valve abnormalities. Mostly, these abnormalities are found on the left but the same sounds can be transposed to the left. Hopefully, if you're reading this you know there are normally two heart sounds:

S₁------------------------S₂----------------------------------------S₁------------------------S₂-------------etc.

The first heart sound (S₁) is that of the mitral valve closing which happens as the ventricle contracts (ventricular systole). This stops blood going into the atrium. Shortly after the aortic valve opens allowing blood to get into the aorta. Once the ventricle stops contracting, the pressure in the ventricle's low so aortic blood starts to try and move back into the ventricle.

The second heart sound (S₂) is that of the aortic valve closing which stops blood going back into the ventricle. After this, the mitral valve opens as the atrium contracts. Let's try and put this all into a simple order:

1. S₁: mitral valve closes (during ventricular systole)
2. Aortic valve opens
3. Ventricle stops contracting, blood starts to try and move from aorta to ventricle
4. S₂: aortic valve closes (during ventricular diastole)
5. Mitral valve opens (during atrial systole/ventricular diastole)
6. Blood moves into ventricles from atria
7. S₁ ...etc.