FAQ on Heart Murmurs and Mechanisms of Turbulent Flow

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During systole, where is the pressure higher: the left ventricle or the left atrium? What about during diastole?

During atrial systole, pressure is greater in the left atrium; during ventricular systole, pressure is greater in the left ventricle. During diastole, left atrial pressure is higher than left ventricular pressure.

During systole, where is the pressure higher, the left ventricle or the aorta? What about during diastole?

During ventricular systole, pressure is greater in the left ventricle. During diastole, aortic pressure is much greater than left ventricular pressure.

During systole, where is the pressure higher, the left ventricle or the right ventricle? What about during diastole?

During ventricular systole, pressure is greater on the left side than on the right because walls of the left ventricle are thicker and more muscular than walls of the right ventricle. This is because the left ventricle is the main pump of the body and is solely responsible for pumping blood throughout the blood-vessels of the entire body.

During diastole pressures in both the left and right ventricles are low.

What is the function of the mitral valve? If the mitral valve is not closing correctly, during which part of the cycle would we be likely to hear evidence of this? What is the clinical term applied to this condition?

The mitral valve is another name for the bicuspid valve that connects the left atrium and ventricle. Mitral insufficiency causes blood to flow backwards from the left ventricle into the left atrium. If the mitral valve is not functioning properly, it’ll affect the Atrial Systole or Ventricular filling (Step one) of the cardiac cycle. This’ll result in a lower than Norman end-diastolic volume (EDV). This is also called Mitral Valve Insufficiency or Incompetence.

If the mitral valve has become too narrow from scarring, during which part of the cycle would we be likely to hear evidence of this? Explain:

We will hear the turbulence during the Atrial Systole or Ventricular filling (Step one) of the cardiac cycle. During this time, the atria are contracting and blood gushes from atria to ventricles.

What is the function of the aortic valve? If the aortic valve is not closing correctly, during which part of the cycle would we be likely to hear evidence of this? Also, what kind of blood pressure would we find? Explain:

The aortic valve connects the left ventricle (the main pump of the heart) to the aorta, the largest artery in the body. If the aortic valve is not closing correctly, blood will tend to reenter the left ventricle, and we’ll hear this murmur during the Ventricular Systole or Ventricular systole, which is the second step of the cardiac cycle. Blood pressure would be lower than normal because of lack of oxygenated blood in the body.

If the aortic valve has become too narrow from scarring, during which part of the cycle would we be likely to hear evidence of this? Explain:

The aortic valve feeds the aorta from the left ventricle. We’ll hear the murmur during the Ventricular Systole or Ventricular systole, which is the second step of the cardiac cycle, when blood is traveling through the valve. This condition is called aortic stenosis.

What is the term we use for a valve that is not closing correctly? What is the term we use for a valve that is too narrow?

Not closing correctly: Insufficiency or Incompetence.

When the valve is too narrow: stenosis.

Suppose there is a defect, a hole, between the left and right ventricle. Would we hear an abnormal sound during systole? During diastole? Explain:

Yes, we would hear a murmur during the systole. During atrial systole, some of the blood may flow across the abnormal shunt, and during ventricular systole, some blood may again flow across the shunt. During diastole we may not hear a murmur as the atria and ventricles are relaxing.

Additional Reading:

Basic Cardiology

1. Electrical Activity of the Heart
2. Heart Muscle Mechanics
3. Heart Sounds and Murmurs
4. Additional FAQ on Heart Sounds and Murmurs
5. Cardiac Conduction Diagram
6. Blood Pressures in Cardiac Chambers
7. What is Pulsus Paradoxus?
8. FAQ on Heart Murmurs and Mechanisms of Turbulent Flow
9. Notes on Fetal Circulation
10. FAQ on Ischemic Myocardial Infarction
11. FAQ on Electrocardiograms / ECG / EKG
12. FAQ on Cardiac Conduction
13. The Heart as a Pump, the Cardiac cycle and Cardiac Output
14. What are the most common causes of aortic stenosis?
15. What is Pulseless Electrical Activity?
16. Causes and Complications of Arteriovenous Fistulas
17. CHADS2 Score for Atrial Fibrillation Stroke Risk
18. How to Reduce Blood Pressure without Medications?
19. Types of Shock
20. Locations of Heart Murmurs on Chest Wall
21. Types of Heart Blocks

Electrocardiogram (EKG/ECG) Topics

1. EKG Chest Leads
2. EKG Limb Leads
3. Quick 12-Lead ECG/EKG Format

Cardiology Videos

1. Video of Cardiology Examination in a Clinical Setting

Medical Images

Useful Medical Images & Diagrams (link opens in a new window)

Related Topics

1. Thorax Anatomy
2. Vascular Disorders
3. Heart Disorders
4. Histology of the Cardiovascular System
5. Jugular Venous Distention Workup
6. ER Chest Pain Workup
7. Cardiac Examination for Internal Medicine
8. FAQ on Blood Pressure
9. FAQ on principles of fluid and flow dynamics of Blood

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