Heart Sounds: Assessment and Clinical Application
Presented by: Cynthia L. Webner DNP, CCNS, ACNP-AG, CCRN-CMC, CHFN
During the routine evaluation of heart sounds the identification of a new murmur is the key to early recognition and ultimately appropriate treatment of valvular heart disease. The identification of abnormal heart sounds in the acute environment can provide advanced assessment data in a critically ill patient and the identification of clinical changes requiring urgent interventions.
This program focuses on the skills required for comprehensive and accurate cardiac auscultation. Beginning with an understanding of how heart sounds relate to the cardiac cycle and the fundamentals of auscultation, this program reviews the normal “lub dub” appreciated with routine auscultation and expands from there. You will develop skills and techniques for auscultation that improve your ability to identify abnormal sounds.
Chronic and acute abnormalities will be reviewed with tips for easy identification. In addition to the most common sounds of aortic stenosis and chronic mitral regurgitation this session covers auscultation abnormalities associated with both chronic and acute situations.
This short 1 hour and 10-minute video recording will teach you both the science and the art of cardiac auscultation. Audio recordings of heart sounds are used to enhance your learning.
1. The cardiac cycle and normal valve function
a.i. Passive ventricular filling
a.ii. Atrial kick
b.i. Isovolumic contraction
2. Tools for auscultation
a. The bell
b. The diaphragm
c. Primary Auscultatory Areas
3. Normal “lub dub”
4. Diastolic Filling Sounds
a. S3 Ventricular Gallop
b. S4 Atrial Gallop
c. Summation Gallop
5. Murmur Fundamentals
e. Pitch / quality
f. Grading systolic murmurs
g. Grading diastolic murmurs
6. Systolic Murmurs
a. Aortic Stenosis
b. Mitral Regurgitation
b.i. Acute: Papillary Muscle Rupture
7. Diastolic Murmurs
a. Aortic Regurgitation
a.i. Acute: Aortic Dissection
a.iii. Austin Flint Murmur
b. Mitral Stenosis
8. Additional Sounds
a. Pericardial Friction Rub
b. Ventricular Septal Rupture
c. Hypertrophic Cardiomyopathy with Obstruction
1.25 hours of continuing education (contact hours) will be offered with this program. CNEA is a provider approved by the California Board of Registered Nursing, provider number 15714.
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