Excellent video, except a point at 0:40. Valsalva maneuver decreases preload, and thus decreases intensity of a mitral stenosis (MS) murmur. Squatting, leg lifts or other maneuvers that increase preload will result an increase of intensity of a MS murmur. Conversely, there are two valvular diseases that a Valsalva will INCREASE the murmur: hypertrophic obstructive cardiomyopathy and mitral valve prolapse. This is because both of these valvular diseases do worse with a decrease in ventricular volume. Thank you for your free series
You guys are too amazing!!! This video is just so perfect. Short yet so thorough. And not to mention that graphic at 1:00 - 1:09. Thank you so much for your help!!!!
Even I struggled with it too............If you read with the cardiac cycle simultaneously n then understand hemodynamics , u will not forget. 1 week max ...........u can cover it up........
I played this video 1:00-1:09 by the slowest rate (0.25) and found that actually the murmur is most obvious at the very late diastole and extending to S1, that's why it was so confusing for me how to tell the murmur is diastolic or systolic before watching this video.
Rheumatic heart Dz is classic for affecting the mitral valve. For mid-age patients, it's mostly Mitral Stenosis (which classically presents with Diastole. murmur with opening snap)
Excellent video. The loud first heart sound you get in mitral stenosis is due to the valve leaflets, which are open in diastole, becoming slammed shut during ventricular contraction in systole, which the first heart sound heralds.
It sounds to me that in this video the graphic doesn't match the sound. I hear the murmur but the graphic highlights S1. Does anyone else see/hear that too? This is when I slow it down to 0.5
@@LifeLineJAT it doesn't say no past infections, it says no current infectious symptoms which rules out infective endocarditis. Rhuematic heart disease is a complication of infectiono with strep group A but rheumatic heart disease is not an infection itself, it is an autoimmune reaction of your body against mitral valve M protein, specifically myosin. this is known as molecular mimicry. type 2 HS rxn
Thank you for your videos but the graphic and the sound do not match When listening the sound there is an obvious gap between the opening snap and the murmur
I can only hear two sounds apart from the murmur. Does S1 merge with the murmur and is therefore not easily audible? The graphic shows S2 and the opening snap as two very clear sounds but S1 is kind of missing
Thank you for this video. It is extremely useful to have a visual to go with the sounds. However, I am a little confused about the comments on the valsalva maneuver. Could you please clarify for me? Your notes say that the murmur increases AFTER the valsalva but the case study says the murmur increases DURING valsalva. Other sources I have read say that the murmur decreases with decreased venous return (valsalva) and increases with increased venous return (such as right after valsalva is over). Is there a mistake in the case study? Or is there something that I am missing? Thanks so much for this information. I really appreciate you making these videos!
More heart sounds and murmurs: medzcool.com/auscultate
Excellent video, except a point at 0:40.
Valsalva maneuver decreases preload, and thus decreases intensity of a mitral stenosis (MS) murmur.
Squatting, leg lifts or other maneuvers that increase preload will result an increase of intensity of a MS murmur.
Conversely, there are two valvular diseases that a Valsalva will INCREASE the murmur: hypertrophic obstructive cardiomyopathy and mitral valve prolapse. This is because both of these valvular diseases do worse with a decrease in ventricular volume.
Thank you for your free series
this is what i was wondering....thanks
You guys are too amazing!!! This video is just so perfect. Short yet so thorough. And not to mention that graphic at 1:00 - 1:09. Thank you so much for your help!!!!
No matter how much i study murmurs,i always forget everything😭😭😭😭
I feel your pain😭😭
Same here
Even I struggled with it too............If you read with the cardiac cycle simultaneously n then understand hemodynamics , u will not forget. 1 week max ...........u can cover it up........
@@c.linfordnitin7390 which lectures would you recommend to best understand learn ECG and CVS to memorize forever...
@@chrizstele5922 to be frank 1 professor in my college taught me this in a CME.......he had a ppt with the cardiac cycle and correlated it............
The graphic was helpful along with speed 0.5 or 0.75 it became easy to understand.
Thanks
Absolutely!
thanks for this suggestion!
Thanks for the idea !
I love that graphic , thank you so much for your help , you've no idea how helpful this is to me. The answer to that question is Rheumatic fever
I played this video 1:00-1:09 by the slowest rate (0.25) and found that actually the murmur is most obvious at the very late diastole and extending to S1, that's why it was so confusing for me how to tell the murmur is diastolic or systolic before watching this video.
Thanks for yur comment i understood very well now🙏🙏
Thanksssss ❤❤❤❤
Thank you!
so helpful! I cant’t tell you how much clearer it is after seeing the graphic! Thank you!
The channel with the most gorgeous videos ever
Rheumatic heart Dz is classic for affecting the mitral valve. For mid-age patients, it's mostly Mitral Stenosis (which classically presents with Diastole. murmur with opening snap)
I’ve always heard my heartbeat like this.
Congrats!
U have MS 😉
Get it checked my buddy😂
I’m 6year médical , this is the day 1/1/2021 ! only day I understood murmurs just for ur help thank u ☺️
THE Best channel on RUclips! Your videos are extremely helpful!!
God. I wish i found this earlier. Creativety meets brilliance. Hats off team.
THANK YOU SO MUCH YOU SAVED MY MED SKU LIFE
I’m a NEET aspirant from India
I actually got goosebumps on hearing this
Good inspiration
Thank you 😊
Best of luck, and best of mehnat 👍🏼
Now for a completely non medical way to listen to this, play no worries be happy in time with the rhythm. You will never forget what this sounds like.
Excellent video. The loud first heart sound you get in mitral stenosis is due to the valve leaflets, which are open in diastole, becoming slammed shut during ventricular contraction in systole, which the first heart sound heralds.
I’m not even a medical student, but this is just kind of cool.
Thank you! This video is very useful and a source of motivation!
I loved the graphic in 1:00
Looks like a background when a person is dancing onstage
THANK YOU SO MUCH!!!
I cant understand why some people would dislike something great and helpful like this video.:)
I just want to thank you so much for the great work
Thank you so so much! Mitral Stenosis is rare in clinical practice and this is great !
well done guys .. I'm a big fan of your work .. keep it up:)
Amazing vid!!! Thank you!
Great explanation and perfect sound.
Thank you
Murmur is heard in late diastole, it is hard to hear S1, i was finding the graph difficult to understand until i played it at 0.25 speed. I loved it!
Thank you so much ✨
This is amazing and very helpful.. Thank you
Best channel
Thank you so much! It is so helpful!
Guys,its better if you listen to it in 0.5x speed. It helped me distinguish the opening snap from S2.
Thank you so and so much.This video inspired me a lot, thanks.
It sounds to me that in this video the graphic doesn't match the sound. I hear the murmur but the graphic highlights S1. Does anyone else see/hear that too? This is when I slow it down to 0.5
I hear the S2 + snap first then the murmur and the S1
Yes! I saw that too
The thing which u r calling murmur is actually a loud S1
nope.the graphics highlights s1 after the murmur is heard.u hear the murmer,then loud s1 comes immefiately after the murmer stops.u got confused there
Agree
Turn it on fast of 0,25 and enjoy the murmer
😂😂😂
Thanks for the video and tht amazing graphics
Best of contents 🌺
Thanks a lot! So helpful
1:00
Great graphics 👌🏽👌🏽👌🏽
It's very helpful vedio, thanks a lot 🙏 😊
Thank you!
The answer is
B. Rheumatic heart disease
how????? ,,,,,,,,,no h/o infection
@@LifeLineJAT Most of the causes is Rheumatic Heart Disease that cause by Beta hemolytic streptococcus group A
@@LifeLineJAT it doesn't say no past infections, it says no current infectious symptoms which rules out infective endocarditis. Rhuematic heart disease is a complication of infectiono with strep group A but rheumatic heart disease is not an infection itself, it is an autoimmune reaction of your body against mitral valve M protein, specifically myosin. this is known as molecular mimicry. type 2 HS rxn
@@silviomartinez7286 but also it says no shortness of breath, but rheumatic heart disease causes that!
Does Valsalva maneuver make the sound quieter?
great workkkkk
Wow wow thanks!
thank you very much
It kind of reminds me of the "ba-dum tsss" drum sound made after a joke, only with a murmur at the end (ba-dum whooosh).
@Medzcool how do we differrntiate opening snap from Split S2 ?
Thank you very much.. Really helpful series of videos!!😍🥰
Thank you for your videos but the graphic and the sound do not match
When listening the sound there is an obvious gap between the opening snap and the murmur
Amazing, Thanks...
You are the best
Thanks a lot. Really really helpful! Are these heart sounds true heart sounds recorded, or simulations?
Graphic representation of murmur doesnt goes properly @1:10 rest of the video is wonderful 👍
I can only hear two sounds apart from the murmur. Does S1 merge with the murmur and is therefore not easily audible? The graphic shows S2 and the opening snap as two very clear sounds but S1 is kind of missing
In the first aid says that standing valsava maneuver (strain phase) decreases this murmur
Can I get an explanation?
standing valsalva decreases preload ...... that means less blood flow through stenosed value which eventually cause a decrease in murmur
Thank you for this video. It is extremely useful to have a visual to go with the sounds. However, I am a little confused about the comments on the valsalva maneuver. Could you please clarify for me? Your notes say that the murmur increases AFTER the valsalva but the case study says the murmur increases DURING valsalva. Other sources I have read say that the murmur decreases with decreased venous return (valsalva) and increases with increased venous return (such as right after valsalva is over). Is there a mistake in the case study? Or is there something that I am missing? Thanks so much for this information. I really appreciate you making these videos!
Im also confused in this point! And if it really will be louder so why aortic stenosis murmur will decrease in intensity in valsalva manuver 🤔🤔
God level Videos
Why I forget this..
After a valsalva maneuver preload will decrease sooo there has to be a decrease sound right?????
😫😫😫 where’s the opening snap??
amazing
thanks, excelent.
grahpic+sound at 1:00
What is the answer for the case?
This sounds like the train coming Bucharest to Targu Mures
S4 is also heard . As it should be present in MS 🤔
Thanks
Is the doubled sound S2+Click (1.18) ? Could it be S2(pulmonary)+S2(aortic)?
How to identify decresendo crescendo
What is the answer? i can't find, is that Rheumatic heart disease?
Ultimate
This was very good.
Watch at .5 from 1 min and you'll get hold of it
I believe Valsalva decreases the intensity of the murmur but otherwise great video
Is there an s4 also i this audio recprding?
sam emmy I think that’s the diastolic opening snap.
01:00
U guys are fuckin awesome.
1:01
I felt the murmur didn't correspond to the graphics. even at 0.5 x speed @.@ OMG
The answer must be B
But it was said no infectious symptoms in the case hmm..
0:59
لا اله الا الله وحده لا شريك له, محمد رسول الله
This is so difficult
This is very similar to S3 gallop :(
diastole is way too short, throws everything off
😊😊
When study murmur I feel GERD 🤮
❤️
these videos are always too fast
Decrease the speed dear
Rheumatic heart disease
B