Heart sounds/murmurs on the boards?

[Daitong]

Hi,

How neccessary is that that we can differentiate heart sounds/murmurs by the audio alone? I understand 'verbally' that aortic stenosis is a holosystolic murmur, but when the audiofiles come, it's rather hard for me to differentiate.

I've come across questions in a USMLERx that utilize the sounds, but they were supplemental and with some logical deductions from the other parts of the question stem, you could ideally reason out the answer without the murmur alone.

Question: On the boards, how important is it to differentiate between the various heart sounds (by audio, not words), or is the question stem generally enough?

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[masaraksh]

I still havn't taken the boards, but it doesn't seem like they'll ask you to listen and then identify stuff like physiologic splitting of s2 vs fixed splitting. Thats waaaay to hard for step 1.

But getting a feel for whether a murmur is systolic vs. diastolic is probably a good idea. Also, probably learn S3 (which IMO seems more likely to show up than S4).

 

[masaraksh]

Also, I'm sure you better be able to tell apart the heart murmurs for cardiology boards

 

[malin]

I had a few murmur questions on my Step 1. On UWorld, you click PLAY, and you listen to the murmur. On Step 1, there are 6 different areas to listen to (APTM valves, both carotid arteries), and there's a little interactive graphic where you can choose which valve you want to listen to, either with the diaphragm and the bell. The patient is also breathing in the graphic, which can change some of the murmur intensities. Sometimes you can answer the question without really listening to the murmur, and sometimes you had to listen to the murmur to be able to answer the question.

 

[worldbeater]

aortic stenosis is a holosystolic murmur,

Holosystolic means a continuous murmur, so you probably meant to say aortic regurgitation

Question: On the boards, how important is it to differentiate between the various heart sounds (by audio, not words), or is the question stem generally enough?

The stem provides enough information to get the answer right. The audio is there just to intimidate you. What I do when reviewing a UWorld question is go through the objective and figure out where I went wrong (and right). Then once I know the answer, THEN I click the audio to listen to it, so I can learn what aortic regurgitation sounds like on the fly.

 

[Skynnyrd]

.

 

[Skynnyrd]

Holosystolic means a continuous murmur, so you probably meant to say aortic regurgitation


The stem provides enough information to get the answer right. The audio is there just to intimidate you. What I do when reviewing a UWorld question is go through the objective and figure out where I went wrong (and right). Then once I know the answer, THEN I click the audio to listen to it, so I can learn what aortic regurgitation sounds like on the fly.

Aortic regurgitation is an early blowing diastolic murmur, not systolic.

 

[worldbeater]

Aortic regurgitation is an early blowing diastolic murmur, not systolic.

You are correct sir, confused it in my head. Thanks.

 

[Celestia]

Thanks S for pointing that out - first thing I thought as well. Holosystolic is MR. AS is systolic crescendo decrescendo.

Regardless of whether or not this stuff is on a test seems like it could use a little review.

Don't forget in real life what you get is the audio.... The murmur doesn't say "hello I am a diastolic rumble."

 

[Faramir]

.

 

[Faramir]

Aortic regurgitation is an early blowing diastolic murmur, not systolic.

Goljan explains it well in his audios

 

[Skynnyrd]

S1...S2BLOOOOWWWWWWWS1....S2BLOOOO

That's exactly how the sound is spelled phonetically

 

[Faramir]

That's exactly how the sound is spelled phonetically

Spoken in the language of the mythical Goljan audio files...

 

[B0ROMIR]

Spoken in the language of the mythical Goljan audio files...

Broth....Brother. It has been too long..

 

[Faramir]

Broth....Brother. It has been too long..

.

 

[iamgonnaeat]

On my exam at least, I didn't really have a description of the sound, just the audio. The question would read, when the doc places a stethoscope on the chest he hears... etc.

 

[zeevee]

Hmm .I have also been told of these audio only questions .@ malin thankyou for the description of the question .
What source besides UW are you using to distinguish between the sounds.To differentiate between systolic and diastolic would be a good start ( I cannot do that still infact I believe that is the hardest to master ) .I can tell a continuous murmur or a blowing sound or an opening snap .
My UW has a very meek sound and its not my computer its the same on my ipad , my phone etc .
Does anyone have a good website or app where they would dissect the sound for us ?

 

[worldbeater]

The question will have enough info for you to give the differential. Audio is just a bonus.