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Explain Systolic Murmurs in heart diease details?
Definition: Murmurs is a series of auditory vibrations that are more prolonged than a sound.Causes: High-energy turbulence call occurs due to:1) High velocity flow.2) Local obstruction or fluid flowing into a channel of larger dimension.3) Combined effect causing vertices and vibratory waveforms.Grading of Murmurs: As recommended by Levine in 1933.Grade 1 : Very faint murmur that can be heard only with special effort.Grade 2: Soft but readily detected murmur.Grade 3: Prominent but not loud murmur.Grade 4: Loud murmur.Grade 5: Very loud murmur can often be heard with rim of stethoscope touching the skin.Grade 6: Murmur loud enough to be heard with stethoscope just removed from contact with chest wall.Grade 4, 5 and 6 murmurs are always accompanied by a thrill. These begin with S,, are crescendo decrescendo in nature and finish before A, (if left sided ejection murmur) or P, (if right sided ejection murmur) and are low to medium frequency sounds even when soft.The two common types of ejection murmurs are:a) Aortic or pulmonary stenosis ejection murmur.b) Systolic flow murmur.
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As heart failure sets in, there is activation of RAS (Fig 2.1). Adrenergic stimulation of beta-1 receptors in juxtaglomerular apparatus of the kidneys results in release of renin.
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