Any good Afib Auscultation Sound Clips?

[brittnic2008]

Does anybody have any good auscultation sound clips of AF and other cardiac arrhythmias??

Thanks in advance!!!

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[Winged Scapula]

Moving to Clinical Rotations...

 

[Pinkertinkle]

af is pretty easy, it goes like beat beat pause beat pause pause beat pause beat etc....

 

[Rendar5]

AFib is not auscultatable diagnosis, like valvular issues. What you hear is an irregularly irregular rhythm, and you get an irregularly irregular pulse on physical exam. There are other causes of irregularly irregular pulses which you don't necessarily need to know as a 3rd or 4th year student (unless you're on a cardiology rotation). Afib is an ECG diagnosis. (So don't write it down as a physical exam sign. You can write it down as a history or an EKG interpretation)

 

[virgo]

As mentioned, A Fib is an EKG finding. If you're really interested in heart sounds, a simple Google search will direct you to some good sites.

 

[45408]

AFib is not auscultatable diagnosis, like valvular issues. What you hear is an irregularly irregular rhythm, and you get an irregularly irregular pulse on physical exam. There are other causes of irregularly irregular pulses which you don't necessarily need to know as a 3rd or 4th year student (unless you're on a cardiology rotation). Afib is an ECG diagnosis. (So don't write it down as a physical exam sign. You can write it down as a history or an EKG interpretation)

This.

It's going to sound wildly irregular, and there won't be a regular pattern to it. A patient with 2nd degree AV block (Mobitz I) would have a regularly occurring irregularity, but a patient with AF is going to be all over the place.

 

[Rendar5]

This.

It's going to sound wildly irregular, and there won't be a regular pattern to it. A patient with 2nd degree AV block (Mobitz I) would have a regularly occurring irregularity, but a patient with AF is going to be all over the place.

I guess if we're gonna go this route of what the irregularly irregular and the regularly irregular rhythms are). aflutter has the potential to be a bit irregular but is usually regular. you can convert between this and afib in some patients. a really bad mobitz 2 (lol as if there's such a thing as a good mobitz 2) is gonna be irregularly irregular, wandering atrial pacemaker would be irregularly irregular (as would multifocal atrial tachycardia). someone with multiple pvcs or who is going into and out of vtach would also sound irregularly irregular. of the oregular irregulars off the otp of my head, mobitz 1 is, it keeps lengthening (subtly), and then drops, if that counts. the bigeminy and trigeminy patterns are also regularly irregular. I think there might be some more but can't think of them off the top of my head.

Either way, just remember, you cannot write down/diagnose any of those abnormal rhythms on your physical exam. You can only put down regularity, rubs/murmurs/gallops and their descriptions, S1/2/3/4, and stuff like "muffled". Leave diagnoses and conditions to the appropriate place

 

[virgo]

Either way, just remember, you cannot write down/diagnose any of those abnormal rhythms on your physical exam. You can only put down regularity, rubs/murmurs/gallops and their descriptions, S1/2/3/4, and stuff like "muffled". Leave diagnoses and conditions to the appropriate place

I keep meaning to ask a cardiologist, but I'm either too busy or they're too busy, so.....

When I document heart tones and I can't hear them too well, I can either chart "muffled" or "distant" from the computer pull down menu.
On most of my morbidly obese patients, I tend to think of their heart tones as "muffled" due to all the adipose tissue and their inability to sit up/lean forward/turn to their left side for better ausculatation. In my more "normal" BMI patients, sometimes their heart tones are faint, and I think of them as more "distant" sounding than "muffled", because if I'm not hearing any kind of rub and there's no reason to think they have a pericardial effusion, I'm thinking it's not really "muffled".

How would you distinguish "muffled" from "distant"?