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认识心脏杂音远离心脏疾病

Heart Sounds and Heart Murmurs, Animation.

当一个健康的心脏跳动的时候 它会发出咚-嗒的响声
When a healthy heart beats, it makes a “lub-dub” sound.
第一个心脏跳动产生的咚声也被称为S1
The first heart sound “ lub ”, also known as S1,
这是由于在心房的血液泵入心室后
is caused by the closing of the AV valves
房室瓣的闭合产生的
after the atria have pumped blood into the ventricles.
第二个心音 嗒嗒声 称为S2
The second heart sound “ dub ”, or S2,
它是由于主动脉瓣和肺动脉瓣的闭合产生的
originates from the closing of the aortic and pulmonary valves,
正好是在心室喷出血液后
right after the ventricles have ejected the blood.
S1和S2之间的间隔便是心室收缩的时间
The time interval between S1 and S2 is when the ventricles contract,
叫收缩期
called systole.
S2和下一个S1的之间的间隔
The interval between S2 and the next S1
是心室舒张和充满血液的时期
is when the ventricles relax and are filled with blood,
叫舒张期
called diastole.
心舒期时间长于心缩期 所以是咚-嗒……
Diastole is longer than systole, hence thelub-dub, lub-dub, lub-dub…
心音主要在胸腔的4个不同部位听诊
Heart sounds are auscultated at 4 different sites
主要与血液流经的
on the chest wall which correspond to
位置和方向一致
the location of blood flow as it passes through
分别为主动脉瓣区 肺动脉瓣区 三尖瓣区和二尖瓣区几个听诊区
the aortic, pulmonic, tricuspid, and mitral valves, respectively
正是因此 相似的缺陷在不同瓣膜上会有差异化的表现
This is how similar defects associated withdifferent valves are differentiated.
心脏杂音是呼呼声 由血液湍流产生
Heart murmurs are whooshing sounds produced by turbulent flow of blood.
杂音的诊断基于杂音在心动周期中发生的时间
Murmurs are diagnosed based on the time they occur in the cardiac cycle,
和血液浓度的变化 以及最适的听诊区域
their changes in intensity over time, and the auscultation site where they are best heard.
比如一般常见的收缩期杂音包括:
Examples of conditions associated with commonsystolic murmurs include:
二尖瓣返流
– mitral valve regurgitation,
当二尖瓣关闭不全时
when the mitral valve does not close properly and blood surges
血液在收缩期返流回左心房
back to the left atrium during systole.
当房室瓣闭合 S1处就开始出现杂音
The murmur starts at S1, when the AV valves close,
并且以同样的强度延续整个收缩期
and maintains the same intensity for the entire duration of systole.
这个全收缩期杂音最易在二尖瓣听诊区 即心尖部听到
This holosystolic murmur is best heard at the mitral region-the apex,
并一直传导到左腋下部
with radiation to the left axilla.
在心脏的另一侧
On the other side of the heart,
三尖瓣返流在时间和形式上类似
a tricuspid valve regurgitation has similar timing and shape,
只是最适听诊区
but it is loudest
在三尖瓣听诊区和声音传导区
in the tricuspid area and the sound radiates up,
沿着胸骨左缘
along the left sternal border.
主动脉瓣狭窄
– aortic valve stenosis,
当主动脉瓣不能正确地张开 血液被迫
when the aortic valve does not open properly and blood is forced
通过狭窄的通道
through a narrow opening.
即血液流出道狭窄
The blood flow starts small,
此杂音在收缩中期增至最强
rises to a maximum in mid-systole at the peak of ventricular contraction,
然后逐渐变弱直到收缩结束
then attenuates toward the endof systole.
引起声音渐强渐弱
This results in a crescendo-decrescendo,
或引起钻石型杂音 紧接着S1
or a diamond-shaped, murmur which starts a short moment after S1.
它常先于由狭窄的瓣膜打开产生的喷射性喀喇声
It is often preceded by an ejection click caused by the opening of the stenotic valve.
主动脉狭窄的杂音
Aortic stenosis murmur is loudest
在主动脉瓣听诊区声音最大 并能传导至颈动脉
in the aortic area and the sound radiates to the carotid
沿颈动脉随着血液流动
arteries in the neck following the directionof blood flow.
在心脏的另一侧
Again, on the other side of the heart,
肺动脉狭窄也有同样的特征
a pulmonic stenosis has the same characteristics but
在肺动脉瓣听诊区能很清楚听到 但不会传导到颈部
is best heard in the pulmonic area and does not radiate to the neck.
其他能引起收缩期杂音的情况包括室间隔缺损
Other conditions that cause audible systolicmurmurs include ventricular septal defect
和二尖瓣脱垂
and mitral valve prolapse.
舒张期杂音的例子包括主动脉瓣回流
An example of diastolic murmurs is aorticvalve regurgitation.
这是当主动脉瓣关闭不全时
This is when the aortic valve does not close properly,
导致血液在舒张期和充盈期
resulting in blood flowing back
回流至左心室
to the left ventricle during diastole- thefilling phase.
随着血液往相反方向流动
As the blood flows in the reverse direction,
杂音很难在主动脉瓣听诊区听到
the murmur is best heard not in the aortic area,
而是在胸骨左缘
but rather along the left sternal border.
声音在舒张期初期最强 即压力差最高时
It peaks at the beginning of diastole when the pressure difference is highest,
之后迅速减弱直到压力均衡
then rapidly decreases as the equilibrium is reached.
其他常见的舒张期杂音 均与肺动脉瓣返流 和二尖瓣狭窄
Other common diastolic murmurs are associatedwith pulmonic regurgitation, mitral stenosis
以及三尖瓣狭窄有关
mitral stenosis and tricuspid stenosis.

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视频概述

是什么在影响我们心脏的健康,那些偶尔不舒服的小毛病背后隐藏着怎样的隐患?一次了解心脏的秘密,健康生活,从此开始。

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翻译译者

山羊堡堡

审核员

审核员SY

视频来源

https://www.youtube.com/watch?v=dBwr2GZCmQM

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