Under normal circumstances, when blood flows in the heart and great blood vessels, it does not produce strange sounds. However, when blood encounters obstacles in the process of flowing, it will form a vortex when it flows through obstacles, and cause vibration of heart valves and blood vessel walls. At this time, in addition to normal heart sounds, there are also noises. With the help of a stethoscope, the doctor can hear it. The distinction between physiological and pathological murmurs. Physiological murmurs can appear in normal people, especially teenagers. Pathological murmurs, on the other hand, "tell" doctors all kinds of "faults" of the heart in different parts with different tones, intensities and frequencies. For example, the heart valve is not fully closed or the valve orifice is narrow, or there are solid floating objects in the heart, or there are "channels" on the atrial septum and interventricular septum that separate the left and right hearts, or the blood vessels of the heart suddenly expand, which will produce such noises. Doctors can learn many secrets of the heart by listening to the noise. Systolic murmurs in the mitral valve area are always reported to the doctor in a wind-blown or seesaw tone: the mitral valve is not closed properly. If there is blood flowing back from the ventricle to the atrium during ventricular contraction, the mitral valve area will rumble like thunder during diastolic period, which shows that the mitral annulus has been narrowed and the blood has been affected, which is mostly caused by rheumatic heart disease. There is a kind of noise with harmonious sound quality, high tone and loud volume, which often imitates whistle, violin and bird calls to tell doctors: the heart valve mold has been perforated or the papillary muscle or chordae tendineae in the ventricle has been broken, and the interventricular septum has holes. These conditions often indicate that the heart is suffering from serious diseases ── such as subacute bacterial endocarditis, chronic rheumatic valvular disease, acute myocardial infarction complicated with ventricular septal perforation or papillary muscle rupture, syphilis heart disease and so on. This kind of noise is the so-called musical noise. Although it sounds good, its meaning is not good. There is also a very unpleasant noise, which is "pericardial fricative sound". It sounds like the squeak, squeak, squeak sound made by people stepping on thick snow. This dry, hoarse voice is telling doctors that the pericardium is thickened and roughened by rheumatism, tuberculosis, suppurative or viral infection. If there is this kind of pericardial fricative sound in the precordial area of uremia patients, it means that the patients have complicated uremic pericarditis, which is a critical feature. Therefore, doctors sometimes refer to it as a "funeral bell"

Heart murmur refers to the abnormal sound generated by the vibration of the ventricular wall, valve or blood vessel caused by the end flow of blood in the heart or blood vessel during the contraction or relaxation of the heart, in addition to heart sounds and extra heart sounds.

It can be divided into:

systolic murmur in apical region

non-pathological systolic murmur in apical region. Rheumatic mitral valve inflammation, rheumatic mitral regurgitation, infective endocarditis-like rheumatic heart disease, systemic lupus erythematosus, scleroderma, papillary muscle insufficiency or broken chordae, idiopathic abdominal cord rupture (coronary heart disease, myocardial infarction), valve relaxation, mitral valve prolapse syndrome Marfan's only thick obstructive cardiomyopathy, and so on. Patent ductus arteriosus with atrial septal defect, endocardial pad defect, hyperthyroid heart disease in pregnancy, anemia heart disease, athlete's heart syndrome with beriberi heart disease, high altitude heart disease, third degree atrioventricular block carcinoid syndrome. Left, failed aortic regurgitation and relative mitral regurgitation.

Diastolic murmur in the apical region of the second heart

Rheumatic mitral stenosis, infective endocarditis, systemic lupus erythematosus like rheumatic heart disease, Austin-Flint murmur of aortic valve insufficiency, large vegetation or thrombus in the mitral valve of left atrial liquid tumor, constrictive pericarditis, patent ductus arteriosus of Hurler syndrome, Lutembacher syndrome, Severe mitral regurgitation, severe aortic regurgitation, ventricular septal defect with large shunt, coarctation of aorta in hypertensive heart disease, dilated cardiomyopathy, anemia heart disease, hyperthyroidism heart disease and third degree atrioventricular block. Diastolic murmur in apical region caused by other reasons < P > Systolic murmur in aortic valve region < P > Rheumatic aortic valve inflammation and rheumatic aortic valve stenosis. Atherosclerosis of aorta, supravalvular aortic stenosis syndrome of hypertensive heart disease, congenital bicuspid aortic valve, syphilitic aortitis of coarctation of aorta, aortic aneurysm, Ebstein malformation, severe aortic insufficiency and complete atrioventricular block. Systolic murmur in aortic valve area caused by hyperthyroidism heart disease, anemia heart disease, carcinoid syndrome and carotid murmur.

Diastolic murmur in four aortic valve regions

Rheumatic aortic valvulitis, Syphilitic aortic regurgitation, infective endocarditis, rheumatic heart disease-like, Marfan syndrome of systemic lupus erythematosus, aortic atherosclerosis, aortic sinus aneurysm rupture caused by hypertension, aortic valve prolapse caused by high ventricular septal defect, aortic valve regurgitation caused by other reasons

Third on the left edge of the fifth sternum, 4 intercostal systolic murmur < P > Non-pathological systolic murmur in infants with ventricular septal defect, pulmonary stenosis or funnel stenosis, mitral regurgitation, aortic stenosis, aortic coarctation, atrial septal defect obstructive primary cardiomyopathy, tricuspid regurgitation, patent ductus arteriosus from right ventricle to right atrium.

Systolic murmur of six pulmonary valve areas

Non-pathological systolic murmur of pulmonary valve Rheumatic pulmonary valvulitis, rheumatic pulmonary valve stenosis, infective endocarditis, congenital pulmonary stenosis, Fallot tetralogy of pulmonary artery and branch stenosis, Lutembacner syndrome, idiopathic pulmonary ectasia, primary pulmonary hypertension, secondary pulmonary hypertension (Eisemmenger syndrome), Rheumatic mitral stenosis, chronic pulmonary heart disease, high altitude heart disease, atrial septal defect of straight back syndrome, anomalous drainage of patent ductus arteriosus, hyperthyroid heart disease in pregnancy, anemia heart disease, beriberi heart disease, carotid murmur.

Diastolic murmur in the seventh pulmonary valve area

Rheumatic pulmonary inflammation, rheumatic pulmonary insufficiency, infective endocarditis, Granam－stell murmur caused by relative pulmonary insufficiency after pulmonary stenosis surgery, primary pulmonary hypertension (rheumatic mitral stenosis, left-right shunt of congenital heart disease), congenital pulmonary aneurysm, anemia heart disease, thyrotoxic heart disease carcinoid syndrome.

systolic murmur in tricuspid area

rheumatic tricuspid inflammation rheumatic tricuspid insufficiency. Infectious endocarditis, papillary muscle insufficiency and valve relaxation. High radiation injury, Ebstein's abnormal pulmonary heart disease, rheumatic mitral valve disease with pulmonary hypertension causing obvious enlargement of the right ventricle, congenital heart disease with a large number of left-right shunt (anomalous pulmonary vein drainage of atrial septal defect), primary pulmonary hypertension.

Diastolic murmur in tricuspid region

Rheumatic tricuspid inflammation, rheumatic tricuspid stenosis and fungal infection. Endometritis congenital tricuspid stenosis, right atrial fluid tumor, right ventricular enlargement caused by mitral stenosis, massive regurgitation of tricuspid insufficiency, massive left and right shunt of atrial septal defect, anemia heart disease, hyperthyroidism heart disease, carcinoid syndrome.

continuous murmur at the bottom of the tenth heart

patent ductus arteriosus, aortic-pulmonary septal defect. Pulmonary arteriovenous sinus aneurysm ruptured human right ventricle (atrium) with congenital coronary arteriovenous malformation, complete anomalous pulmonary venous drainage with tricuspid atresia, ventricular septal defect with aortic regurgitation after intrathoracic artery anastomosis, mitral regurgitation with aortic regurgitation, aortic regurgitation with stenosis < P > XI. Noise in other parts

① Head auscultation: benign head murmur and eyeball murmur;

② neck auscultation: jugular vein ying ying sound and subclavian artery murmur. Thyroid murmur supraclavicular artery murmur;

③ Chest and back murmur: pleural adhesion murmur and breast murmur;

④ Abdominal vascular murmur: hepatic arterial murmur, hepatic venous murmur, murmur caused by renal artery stenosis, murmur caused by compression of abdominal aorta and its branches, murmur of pregnancy from abdominal aorta and its branches, and vascular murmur of spinal costal angle;

⑤ auscultation of limbs: arteriovenous thinness, aneurysm hemangioma, aortic valve insufficiency.

See what kind of murmur it is.

Normally, only two heart sounds can be heard. If it is abnormal, three heart sounds can appear, mostly due to valve insufficiency or blood flow changes, and the vibration of the papillary muscles and chordae tendineae. It depends on what happens to your heart sounds. After observation, if there are other conscious symptoms, make an ECG.

Heart murmur refers to heart sounds and extra heart sounds. There are several reasons for the noise: accelerated blood flow, stenosis of valve orifice, valve insufficiency, abnormal blood flow channel, abnormal heart structure, and large hemangioma-like expansion. The loudest murmur is related to the lesion. If the murmur is loudest at the apex of the heart, it indicates that the mitral valve is diseased. Hope useful to you