Presentation on theme: "Valve Defects /Cardiac Cycle"— Presentation transcript:
1 Valve Defects /Cardiac Cycle UNM School of MedicineCV/Pulmonary/Renal Block
2 Normal Cardiac Cycle and Heart Sounds Refer to this normal cardiac cycle when studying the abnormal cycles in the following slidesView the PowerPoint in slide show mode in order for sound files to work.Click here for normal heart sounds
3 Aortic regurgitation 1 Diastolic decrescendo murmur Pressure gradient =aortic pressure - left ventricularPressurePressure gradient decreases duringDiastole as aortic pressure falls andLV pressure rises due to fillingNote the large pulse pressure due torapid “runoff” of blood to circulationplus back into ventricle.Blood begins filling ventricle beforeMitral valve opens (back flow fromAorta).
4 Aortic regurgitation 2There can also be a systolic murmur due to large stroke volume and turbulent flowDuring ejectionEDM – early diastolic murmurAFM – Austin Flint murmur – mitral leaflet displacement & turbulent back flow
5 Aortic stenosisMurmur intensity depends on pressure gradient across aortic valve; LV pressure – aortic pressure.P increases, then decreases, resulting in crescendo – decrescendo systolic murmur.The time for left ventricular systole will be prolonged (while the time for left ventricular diastole is shortened).
6 Mitral regurgitationMurmur depends on pressure difference across the mitral valveP = LV – LA pressureP remains large and relatively constant during ejection resulting in a holosystolic murmur.LA pressure increases due to backflow across incompetent valve
7 Mitral StenosisMurmur intensity depends on pressure difference across mitral valve.P = LA – LVHighest at the beginning,resulting in diastolicdecrescendo murmur with a rise in pressure(crescendo) just before systole as atria contracts
9 Practice Question: The cardiac cycle and murmur of a patient in the cardiac cath lab is shown below. The valve defect in this patient is:Aortic regurgitationAortic stenosisMitral regurgitationMitral stenosis