Why is the crescendo-decrescendo systolic murmur best heard at the cardiac base?












2















I'm writing a paper and came across a very specific question about heart sounds.



Why is the crescendo-decrescendo systolic murmur best heard at the cardiac base? and why does it radiate to carotids?



Apparently, this question has a definitive answer.
I've scoured google, but can't find a single paper that discusses the question (has answers). I'd appreciate any help or a reference that might help me find an answer.










share|improve this question







New contributor




Grigio is a new contributor to this site. Take care in asking for clarification, commenting, and answering.
Check out our Code of Conduct.

























    2















    I'm writing a paper and came across a very specific question about heart sounds.



    Why is the crescendo-decrescendo systolic murmur best heard at the cardiac base? and why does it radiate to carotids?



    Apparently, this question has a definitive answer.
    I've scoured google, but can't find a single paper that discusses the question (has answers). I'd appreciate any help or a reference that might help me find an answer.










    share|improve this question







    New contributor




    Grigio is a new contributor to this site. Take care in asking for clarification, commenting, and answering.
    Check out our Code of Conduct.























      2












      2








      2








      I'm writing a paper and came across a very specific question about heart sounds.



      Why is the crescendo-decrescendo systolic murmur best heard at the cardiac base? and why does it radiate to carotids?



      Apparently, this question has a definitive answer.
      I've scoured google, but can't find a single paper that discusses the question (has answers). I'd appreciate any help or a reference that might help me find an answer.










      share|improve this question







      New contributor




      Grigio is a new contributor to this site. Take care in asking for clarification, commenting, and answering.
      Check out our Code of Conduct.












      I'm writing a paper and came across a very specific question about heart sounds.



      Why is the crescendo-decrescendo systolic murmur best heard at the cardiac base? and why does it radiate to carotids?



      Apparently, this question has a definitive answer.
      I've scoured google, but can't find a single paper that discusses the question (has answers). I'd appreciate any help or a reference that might help me find an answer.







      cardiology heart-disease heart






      share|improve this question







      New contributor




      Grigio is a new contributor to this site. Take care in asking for clarification, commenting, and answering.
      Check out our Code of Conduct.











      share|improve this question







      New contributor




      Grigio is a new contributor to this site. Take care in asking for clarification, commenting, and answering.
      Check out our Code of Conduct.









      share|improve this question




      share|improve this question






      New contributor




      Grigio is a new contributor to this site. Take care in asking for clarification, commenting, and answering.
      Check out our Code of Conduct.









      asked 2 hours ago









      GrigioGrigio

      1134




      1134




      New contributor




      Grigio is a new contributor to this site. Take care in asking for clarification, commenting, and answering.
      Check out our Code of Conduct.





      New contributor





      Grigio is a new contributor to this site. Take care in asking for clarification, commenting, and answering.
      Check out our Code of Conduct.






      Grigio is a new contributor to this site. Take care in asking for clarification, commenting, and answering.
      Check out our Code of Conduct.






















          1 Answer
          1






          active

          oldest

          votes


















          2














          It's not, unless you are using the term "base" to refer to the aortic root of the heart rather than the apex.



          A systolic "crescendo-decrescendo murmur" is the classic description for the murmur resulting from aortic stenosis. The aortic valve is best auscultated at the right upper sternal border.



          In the below diagram, the actual valve locations inside the heart are indicated by the colored ovals, but the location that you best HEAR the valve-related murmurs are indicated by the A P T M in circles for Aortic, Pulmonic, Tricuspid, and Mitral.



          enter image description here



          You hear a murmur at a different location than the valve itself because of fluid physics and acoustics. A cardiac murmur is a vibratory process occurring due to fluid mechanics; pathological murmurs are due to blood flow along abnormalities in heart structures. If you look at the course of the aorta, from the aortic valve to the carotids etc, you can see how vibration from narrowed aortic valve would easily radiate there.



          Anecdotally, I've often heard it more clearly at the LUSB (left upper sternal border, which is generally the pulmonic region) than the right (RUSB), and I'm not sure why - but it was never the apex where I heard it most clearly. There must be some confusion in your sources.



          References:




          • Med school website U Wisc

          • AAFP Murmur Evaluations in Peds


          • Harrison's IM (great medical text but lots of detail)

          • Another detailed medical text






          share|improve this answer
























          • Thank you, this is very helpful! Could you please elaborate more on the patho of the radiation of the carotids? I am having a hard time analyzing that part of the question.

            – Grigio
            30 mins ago













          Your Answer








          StackExchange.ready(function() {
          var channelOptions = {
          tags: "".split(" "),
          id: "607"
          };
          initTagRenderer("".split(" "), "".split(" "), channelOptions);

          StackExchange.using("externalEditor", function() {
          // Have to fire editor after snippets, if snippets enabled
          if (StackExchange.settings.snippets.snippetsEnabled) {
          StackExchange.using("snippets", function() {
          createEditor();
          });
          }
          else {
          createEditor();
          }
          });

          function createEditor() {
          StackExchange.prepareEditor({
          heartbeatType: 'answer',
          autoActivateHeartbeat: false,
          convertImagesToLinks: false,
          noModals: true,
          showLowRepImageUploadWarning: true,
          reputationToPostImages: null,
          bindNavPrevention: true,
          postfix: "",
          imageUploader: {
          brandingHtml: "Powered by u003ca class="icon-imgur-white" href="https://imgur.com/"u003eu003c/au003e",
          contentPolicyHtml: "User contributions licensed under u003ca href="https://creativecommons.org/licenses/by-sa/3.0/"u003ecc by-sa 3.0 with attribution requiredu003c/au003e u003ca href="https://stackoverflow.com/legal/content-policy"u003e(content policy)u003c/au003e",
          allowUrls: true
          },
          noCode: true, onDemand: true,
          discardSelector: ".discard-answer"
          ,immediatelyShowMarkdownHelp:true
          });


          }
          });






          Grigio is a new contributor. Be nice, and check out our Code of Conduct.










          draft saved

          draft discarded


















          StackExchange.ready(
          function () {
          StackExchange.openid.initPostLogin('.new-post-login', 'https%3a%2f%2fmedicalsciences.stackexchange.com%2fquestions%2f18518%2fwhy-is-the-crescendo-decrescendo-systolic-murmur-best-heard-at-the-cardiac-base%23new-answer', 'question_page');
          }
          );

          Post as a guest















          Required, but never shown

























          1 Answer
          1






          active

          oldest

          votes








          1 Answer
          1






          active

          oldest

          votes









          active

          oldest

          votes






          active

          oldest

          votes









          2














          It's not, unless you are using the term "base" to refer to the aortic root of the heart rather than the apex.



          A systolic "crescendo-decrescendo murmur" is the classic description for the murmur resulting from aortic stenosis. The aortic valve is best auscultated at the right upper sternal border.



          In the below diagram, the actual valve locations inside the heart are indicated by the colored ovals, but the location that you best HEAR the valve-related murmurs are indicated by the A P T M in circles for Aortic, Pulmonic, Tricuspid, and Mitral.



          enter image description here



          You hear a murmur at a different location than the valve itself because of fluid physics and acoustics. A cardiac murmur is a vibratory process occurring due to fluid mechanics; pathological murmurs are due to blood flow along abnormalities in heart structures. If you look at the course of the aorta, from the aortic valve to the carotids etc, you can see how vibration from narrowed aortic valve would easily radiate there.



          Anecdotally, I've often heard it more clearly at the LUSB (left upper sternal border, which is generally the pulmonic region) than the right (RUSB), and I'm not sure why - but it was never the apex where I heard it most clearly. There must be some confusion in your sources.



          References:




          • Med school website U Wisc

          • AAFP Murmur Evaluations in Peds


          • Harrison's IM (great medical text but lots of detail)

          • Another detailed medical text






          share|improve this answer
























          • Thank you, this is very helpful! Could you please elaborate more on the patho of the radiation of the carotids? I am having a hard time analyzing that part of the question.

            – Grigio
            30 mins ago


















          2














          It's not, unless you are using the term "base" to refer to the aortic root of the heart rather than the apex.



          A systolic "crescendo-decrescendo murmur" is the classic description for the murmur resulting from aortic stenosis. The aortic valve is best auscultated at the right upper sternal border.



          In the below diagram, the actual valve locations inside the heart are indicated by the colored ovals, but the location that you best HEAR the valve-related murmurs are indicated by the A P T M in circles for Aortic, Pulmonic, Tricuspid, and Mitral.



          enter image description here



          You hear a murmur at a different location than the valve itself because of fluid physics and acoustics. A cardiac murmur is a vibratory process occurring due to fluid mechanics; pathological murmurs are due to blood flow along abnormalities in heart structures. If you look at the course of the aorta, from the aortic valve to the carotids etc, you can see how vibration from narrowed aortic valve would easily radiate there.



          Anecdotally, I've often heard it more clearly at the LUSB (left upper sternal border, which is generally the pulmonic region) than the right (RUSB), and I'm not sure why - but it was never the apex where I heard it most clearly. There must be some confusion in your sources.



          References:




          • Med school website U Wisc

          • AAFP Murmur Evaluations in Peds


          • Harrison's IM (great medical text but lots of detail)

          • Another detailed medical text






          share|improve this answer
























          • Thank you, this is very helpful! Could you please elaborate more on the patho of the radiation of the carotids? I am having a hard time analyzing that part of the question.

            – Grigio
            30 mins ago
















          2












          2








          2







          It's not, unless you are using the term "base" to refer to the aortic root of the heart rather than the apex.



          A systolic "crescendo-decrescendo murmur" is the classic description for the murmur resulting from aortic stenosis. The aortic valve is best auscultated at the right upper sternal border.



          In the below diagram, the actual valve locations inside the heart are indicated by the colored ovals, but the location that you best HEAR the valve-related murmurs are indicated by the A P T M in circles for Aortic, Pulmonic, Tricuspid, and Mitral.



          enter image description here



          You hear a murmur at a different location than the valve itself because of fluid physics and acoustics. A cardiac murmur is a vibratory process occurring due to fluid mechanics; pathological murmurs are due to blood flow along abnormalities in heart structures. If you look at the course of the aorta, from the aortic valve to the carotids etc, you can see how vibration from narrowed aortic valve would easily radiate there.



          Anecdotally, I've often heard it more clearly at the LUSB (left upper sternal border, which is generally the pulmonic region) than the right (RUSB), and I'm not sure why - but it was never the apex where I heard it most clearly. There must be some confusion in your sources.



          References:




          • Med school website U Wisc

          • AAFP Murmur Evaluations in Peds


          • Harrison's IM (great medical text but lots of detail)

          • Another detailed medical text






          share|improve this answer













          It's not, unless you are using the term "base" to refer to the aortic root of the heart rather than the apex.



          A systolic "crescendo-decrescendo murmur" is the classic description for the murmur resulting from aortic stenosis. The aortic valve is best auscultated at the right upper sternal border.



          In the below diagram, the actual valve locations inside the heart are indicated by the colored ovals, but the location that you best HEAR the valve-related murmurs are indicated by the A P T M in circles for Aortic, Pulmonic, Tricuspid, and Mitral.



          enter image description here



          You hear a murmur at a different location than the valve itself because of fluid physics and acoustics. A cardiac murmur is a vibratory process occurring due to fluid mechanics; pathological murmurs are due to blood flow along abnormalities in heart structures. If you look at the course of the aorta, from the aortic valve to the carotids etc, you can see how vibration from narrowed aortic valve would easily radiate there.



          Anecdotally, I've often heard it more clearly at the LUSB (left upper sternal border, which is generally the pulmonic region) than the right (RUSB), and I'm not sure why - but it was never the apex where I heard it most clearly. There must be some confusion in your sources.



          References:




          • Med school website U Wisc

          • AAFP Murmur Evaluations in Peds


          • Harrison's IM (great medical text but lots of detail)

          • Another detailed medical text







          share|improve this answer












          share|improve this answer



          share|improve this answer










          answered 1 hour ago









          DoctorWhomDoctorWhom

          4,4611934




          4,4611934













          • Thank you, this is very helpful! Could you please elaborate more on the patho of the radiation of the carotids? I am having a hard time analyzing that part of the question.

            – Grigio
            30 mins ago





















          • Thank you, this is very helpful! Could you please elaborate more on the patho of the radiation of the carotids? I am having a hard time analyzing that part of the question.

            – Grigio
            30 mins ago



















          Thank you, this is very helpful! Could you please elaborate more on the patho of the radiation of the carotids? I am having a hard time analyzing that part of the question.

          – Grigio
          30 mins ago







          Thank you, this is very helpful! Could you please elaborate more on the patho of the radiation of the carotids? I am having a hard time analyzing that part of the question.

          – Grigio
          30 mins ago












          Grigio is a new contributor. Be nice, and check out our Code of Conduct.










          draft saved

          draft discarded


















          Grigio is a new contributor. Be nice, and check out our Code of Conduct.













          Grigio is a new contributor. Be nice, and check out our Code of Conduct.












          Grigio is a new contributor. Be nice, and check out our Code of Conduct.
















          Thanks for contributing an answer to Medical Sciences Stack Exchange!


          • Please be sure to answer the question. Provide details and share your research!

          But avoid



          • Asking for help, clarification, or responding to other answers.

          • Making statements based on opinion; back them up with references or personal experience.


          To learn more, see our tips on writing great answers.




          draft saved


          draft discarded














          StackExchange.ready(
          function () {
          StackExchange.openid.initPostLogin('.new-post-login', 'https%3a%2f%2fmedicalsciences.stackexchange.com%2fquestions%2f18518%2fwhy-is-the-crescendo-decrescendo-systolic-murmur-best-heard-at-the-cardiac-base%23new-answer', 'question_page');
          }
          );

          Post as a guest















          Required, but never shown





















































          Required, but never shown














          Required, but never shown












          Required, but never shown







          Required, but never shown

































          Required, but never shown














          Required, but never shown












          Required, but never shown







          Required, but never shown







          Popular posts from this blog

          Liste der Baudenkmale in Friedland (Mecklenburg)

          Single-Malt-Whisky

          Czorneboh