Why is the crescendo-decrescendo systolic murmur best heard at the cardiac base?
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
asked 2 hours ago
GrigioGrigio
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.
add a comment |
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
asked 2 hours ago
GrigioGrigio
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.
add a comment |
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
asked 2 hours ago
GrigioGrigio
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.
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
cardiology heart-disease heart
asked 2 hours ago
GrigioGrigio
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.
asked 2 hours ago
GrigioGrigio
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.
asked 2 hours ago
GrigioGrigio
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.
asked 2 hours ago
GrigioGrigio
1134
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.
add a comment |
add a comment |
1 Answer
1
active
oldest
votes
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.
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
answered 1 hour ago
DoctorWhomDoctorWhom
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
add a comment |
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.
Sign up or log in
StackExchange.ready(function () {
StackExchange.helpers.onClickDraftSave('#login-link');
});
Sign up using Google
Sign up using Facebook
Sign up using Email and Password
Post as a guest
Required, but never shown
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
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.
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
answered 1 hour ago
DoctorWhomDoctorWhom
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
add a comment |
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.
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
answered 1 hour ago
DoctorWhomDoctorWhom
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
add a comment |
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.
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
answered 1 hour ago
DoctorWhomDoctorWhom
4,4611934
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.
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
answered 1 hour ago
DoctorWhomDoctorWhom
4,4611934
answered 1 hour ago
DoctorWhomDoctorWhom
4,4611934
answered 1 hour ago
DoctorWhomDoctorWhom
4,4611934
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
add a comment |
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
add a comment |
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.
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.
Sign up or log in
StackExchange.ready(function () {
StackExchange.helpers.onClickDraftSave('#login-link');
});
Sign up using Google
Sign up using Facebook
Sign up using Email and Password
Post as a guest
Required, but never shown
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
Sign up or log in
StackExchange.ready(function () {
StackExchange.helpers.onClickDraftSave('#login-link');
});
Sign up using Google
Sign up using Facebook
Sign up using Email and Password
Post as a guest
Required, but never shown
Sign up or log in
StackExchange.ready(function () {
StackExchange.helpers.onClickDraftSave('#login-link');
});
Sign up using Google
Sign up using Facebook
Sign up using Email and Password
Post as a guest
Required, but never shown
Sign up or log in
StackExchange.ready(function () {
StackExchange.helpers.onClickDraftSave('#login-link');
});
Sign up using Google
Sign up using Facebook
Sign up using Email and Password
Sign up using Google
Sign up using Facebook
Sign up using Email and Password
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
