History
A 60-year-old woman who is the CEO of an electronics company in Silicon Valley, presents for a history and physical required for life insurance authorization. There is no prior history of stroke, neuromuscular disease or a transient ischemic attack (TIA).
Use the 'auscultation' link above to virtually listen to this patient's heart and carotid sounds.
Auscultation Tips
Significant independent predictors of the presence of a confirmed cardiac lesion:
- A loud murmur of intensity 3 or greater.
- Best heard at the pulmonic location (2LICS).
- Harsh sound.
- Pansystolic murmur.
- Systolic click.
- Abnormal second heart sound - fixed splitting during respiration.
Authors and Sources
Authors and Reviewers
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Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
- Lung sounds provided by Diane Wrigley, PA
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Heart sounds mentorship by W. Proctor Harvey, MD>
- Reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
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Last Update: 11/10/2022
Sources
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Heart Sounds and Murmurs Across the Lifespan (with CD)
by Dr Barbara Ann Erickson
Publisher: Mosby
ISBN-10: 0323020453; ISBN-13: 978-0323020459 -
Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
Elsevier-Health Sciences Division
Barbara A. Erickson, PhD, RN, CCRN -
Heart Sounds Made Easy with CD-ROM: (with CD-ROM) 2nd Edition
Anthony P. Salmon
ISBN-13: 978-0443069079 - NCBI Review of Heart Sounds and Murmurs: A Practical Guide
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The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds And Murmurs
Jonathan Keroes, David Lieberman
Publisher: Lippincott Williams & Wilkin)
ISBN-10: 0781784425; ISBN-13: 978-0781784429 -
Ventricular Function Curves in the Exercising Dog
JONATHAN KEROES , ROGER R. ECKER , and ELLIOT RAPAPORT
Circulation Research, Vol. 25, No. 5 -
Electrocardiographic changes associated with ritodrine-induced maternal tachycardia and hypokalemia
American Journal of Obstetrics Gynecology, VOLUME 154, ISSUE 4, P921-923, APRIL 01, 1986
Susan K Hendricks, MD, Jonathan Keroes, MD, Michael Katz, MD -
A Multimedia Guide to Heart Sounds and Murmurs
January 2007 JAMA The Journal of the American Medical Association 297(2):217-218
DOI:10.1001/jama.297.2.217. M. Saleem Seyal, MD, Reviewer - Clinical Heart Disease
W Proctor Harvey, MD
Laennec Publishing; 1st edition (January 1, 2009)
60-year-old woman executive requests physical for life insurance authorization
