Heart Murmurs | Locations, Maneuvers, Buzzwords

[@DirtyMedicine]

for the record, there are 2 small corrections: (1) The slides show two S1's marked on the visual representation of the murmurs. Obviously, it should say S1 and S2. (2) Mitral Stenosis is a diastolic murmur, however, our video incorrectly depicts it as being systolic on the slide about MS (the visual representation). Also (not a correction), remember that Aortic Regurgitation is described as a "blowing" murmur. That's all. The video is still bomb diggity awesome if I may say so myself

[@jensonmathew8437]

Hey Dirty, so I believe [Plz correct me if I'm wrong] you need to add a point in the case of Afterload. The exceptions should include HOCM, MVP, and Aortic Stenosis b/c an Increase in Afterload (Handgrip) also decreases the blood flow through the stenotic valve, AS. Great video series. Thanks for the reviews! Also great Pneumonic is RILE Right sided-Inspiration Left sided-Expiration

[@PinkUnicornful]

@@jensonmathew8437 That is correct

[@007imdadullah]

You are the chosen one. The neo of medicine. The keeper of mnemonics. The master of medicine.

[@blackcat2277]

Please ,do make a video about ASD,VSD and PDA.I follow your channel from Turkey.And I really need to learn it.I don't understand clearly when I read it from medical books.Please,help me🙏

[@poorasslawstudent]

Dirty, you need to make your slides available. I'd pay for that shit.

[@sandmanw07]

A professor at my school came up with a pretty great memory hook that I thought I would share: "(h)ARD fall, ASS bump, MSD (missed) u, MRS thru" ARD = Aortic Regurg, Diastolic; fall = decrescendo \ ASS = Aortic Stenosis, Systolic; bump = crescendo-decrescendo / \ MSD = Mitral Stenosis, Diastolic; u = decrescendo-crescendo \_/ MRS = Mitral Regurg, Systolic; thru = holo-systolic --- If you take a hARD fall, you'll have an ASS bump, if someone says they MSD you, then you and your MRS are thru Pulmonic follows same rules as aortic (in pulmonic area), Tricuspid follows same rules as mitral (in tricuspid area)

[@aadithyanarayanan2978]

I cannot thank you and your professor enough 🤩

[@rosaliahauwanga9497]

Wow thanks

[@omarmaasarji7472]

The most beneficial comment I’ve ever read 👍👍well done champ 👍👍👏👏

[@nishaniusmle4248]

Thanks Parker Greider

[@nadeenhider9286]

thank you thank you thank you!!!!

[@alexanderlam7897]

Used this video last year for step 1 and it came in super handy. Studying for step 2 now and I'm still getting questions right from what I learned on here a year ago. Just wanted to come back and say how clutch y'all are. Seriously. Thanks for doing what you do!

[@ZergforLoser]

You are far better, in terms of quality and details, than most of the lecturers in medical school. I think the lecturer should just turn your video during lecture time and leave. This will benefit all of us.

[@fai5734]

Agree 100%!!

[@Lennonlashe]

Have been going madd for hours trying to understand WHY HOCM is louder with decreased pre-load. None of these board review books or videos have an answer. U-World just says “that’s how it is”. Finally, a video that explains it in somewhat of an understandable concept. Understanding WHY always helps, and this video at least attempts to do that. Thank you guys, great content, keep up the great work!

[@pranuthiratna4722]

After going to b&b, USMLE Rx,UW, FA i almost gave up on understanding systolic vs diastolic murmurs and was ready to just memorize them without logic.THANK YOU DIRTY, its soo simple to understand now!Legit took me just 5 minutes to understand the entire thingy. This channel has to be a standard recommendation for all those preparing for STEP1.PERIOD.

[@boredtodeath741]

my god i don't even know what I learned in med school in those long lectures and paying thousands of dollars. We should just pay you instead

[@SublimeInfidel]

Seriously though.... I always thought it would be better just to get the resources and study independently for Step 1 for two years instead of attending pointless lectures. Students would have higher scores with a fraction of the debt.

[@itsgonnabeanaurfromme]

Yikes. Guessing you guys go to an American med school? Worst education for the worst doctors

[@manalashraf7360]

Best way to thank you is by NOT skipping the adds 😂

[@joellapp2046]

You guys are awesome! A mnemonic I got from a friend that you guys might like: “if your arms were chopped into parts, you will probably die” so ARMS PRTS represent all the DIastolic murmurs.

[@deryasadioglu1115]

What is prts

[@skyrusalive86]

@@deryasadioglu1115 pulmonic regurge and tricuspid stenosis

[@talhakhan6729]

To add to this: You know that creepy thing where people whisper or eat gherkins into the microphone? It's called ASMR... P.S - it's Too Rude. Therefore ASMR PSTR for systolic.

[@luna.kashyap1313]

When medical students across borders were in distress .....but in desperation to understand concepts.....GOD CREATED DIRTY USMLE FOR THEIR SAVIOUR ❣️❣️❣️❣️❣️

[@taylormartinez8013]

I'm only a minute or so into this video and I am absolutely blown away. I always struggle with this topic and it causes a lot of anxiety when answering practice questions, but this has made my life so much easier. Thank you so much!!!

[@ammarakhan6255]

I have been legit learning murmurs since morning and I have learned more in 22 mins than I did the whole day.I I can't tell you how thankful I am for this.

[@foureyedreview1160]

I was worrying so much about my upcoming cardiology exam and this 22 min video has cleared my confusion so well. Kudos

[@joshalum732]

Amazing... My UWorld scores have been going up thanks to your videos. Thanks!

[@ZoePfeffercorn]

I finally understand heart murmurs. Cardiac is not my forte I am so glad I found this

[@Cakeitupanotch]

After I pass NP boards this friday and secure a job, I promise I will donate. I owe you.

[@vitrify1325]

best cardiology lecture about this topic hands down thank you so much

[@asifjamal1358]

I passed my step 1. Thank you Dirty medicine you saved a lot of time for me. Your videos are amazing

[@Dr_Shin]

I love you DM. None of my professors were able to explain this clearly. Some of them even get confused when they are talking without thinking. I was always confused by this topic, but now you clarified everything.

[@worldsokayestmedic4568]

Wow dude, in the first ten seconds I listened, you've already exceeded so many other videos. I love the mechanistic "logic" of how/when a sound would be heard. Thanks!

[@IngridG-q5u]

Thank you sm!!! Taught my 4 hr lecture in 22 minutes!!

[@Eddykurrent]

Thank you for this lecture. I finally got an understanding of this concept that has been giving me tough times.

[@symphonicskies300]

Thank you for all that you do for making notoriously difficult concepts easy to understand and memorable.

[@mr-beanblue8567]

just to be honest if you have a private channel I would register and pay for it ,what you are doing for med students is extremely helpful .God bless you and reward you with all your wishes .

[@anagabrielaserrano4648]

Step 1 checked, Step 2 checked, recapping it for Step 3. Dirty, you are the OG & a Genius

[@Benboy887]

You absolute legend, Ijust got wrecked with amboss cardio but now I can understand this stuff. Much appreciated

[@madelinemichaud8009]

This video is awesome, I was able to get all of the heart murmur questions on my exam right thanks to this video. I highly recommend! Thanks so much!

[@hamadrashid2285]

Just some more mnemonics Essentially aortic goes with pulmonic and mitral with tricuspid. For aortic - ASs (aortic stenosis systolic) AIDs (alrtic insufficiency (regurge) diastolic) Mitral - MSD (Mitral stenosis diastolic) I've remembered this as Mahinder singh dhoni a famous Indian cricketer MRS - Mitral regurgitation systolic Another for quickly remembering which among mitral/tricuspid is left or right, there's a T when you write a capital R (somewhat if you see it) but not an a M so Tricuspid is Right

[@yumnahayat310]

Thanks to your videos i now finally understand a lot of concepts I didn’t in med school. I will forever be grateful

[@user-yehia]

Words can't explain how grateful I am!

[@doctorh5413]

This is truly a great help for me. Really appreciate your video. MS:questions also come with recent travel history aka immigrants, pregnant women. PDA: cont. machine like murmur. Loudest @s2, best heard @ Lt-infraclavicular area. VSD: loud/harsh/high-pitch holo systolic (pansystolic) murmur. Radiates over Pre-cordium. ||||||||||||||||||| Thanks

[@fariharifa8848]

May the person get all the blessings in his life who has made this easy for us!

[@alwayshigh9216]

tysm. tomorrow is my exam & this is the last topic that im reviewing. plis pray for me guys.

[@samherat7302]

I liked this video. Very good tips!! Alas during my medical student time we were learning it the hard way and forgetting the easy way!!

[@morganartis4182]

this video helped me understand these murmurs tremendously! cannot thank you enough!!

[@Dada-jr9sn]

Hey, good job. This is far better than all the long lectures I have attended. Concise and loaded.

[@N_k137]

This is absolutely genius 👏 🙌 you literally not only save our career but the lives of our fure patients also ❤❤❤❤❤❤ thank youuuuuuuuuuuuuuuuuuu ❤❤❤❤❤❤❤❤❤❤❤

[@cassandracusackcurbelo2519]

I only wish I'd have watched this sooner! I struggled with this for YEARS and this vid is what finally put it together for me. Thanks so so SO much!

[@MicheleKealy]

excellent video, thank you so much. You have helped me a lot for my cardio exam

[@jangavis7170]

Wish this was around when I went to med school 20 years ago. Nevertheless, it is helping for re-certification of the Boards. Thanks so much. You are incredible!

[@ulukbekzhumaliev2588]

If you listened this 20 years ago, it would be same like it was 20 years ago. If you listen sth you already know is easy to understand.

[@samurnasabir4487]

I was struggling with this topic. You guys made it super easy! Thanks.

[@itsjustgettingeasier1843]

I was so confused about the murmurs. Thanks a lot!

[@priyam1550]

Thank you! Finally understand how murmurs increase and decreade!

[@maryc5905]

currently on dedicated, this is amazing!!!!!!!!! thank you so much!!! super clear and helpful!!

[@jennyvalentin5188]

Thanks million, will be reviewing for NP boards in January and I will be reviewing all your videos. Thank you sooooo much.

[@MsStarr6]

this video nailed it with learning about the different murmurs.. this will definitely help me understand the etiology and functional component of each murmur while studying for HMPR during the advanced nurse practitioner program ..

[@johndoe-rz4zv]

mnemonic for systolic murmurs: V TRAPS MR. P (it's dirty) VSD Tricuspid Regurg Aortic/Pulmonic Stenosis Mitral Regurge/Prolapse

[@libiansandhu3925]

ur really a MVP in field of medicine lectures..as always u nailed it

[@eduardomoya3648]

Tengo mi step2ck en una semana y este es el MEJOR video que que visto para soplos !!! I’m taking my step 2ck in a week and this is the BEST video that have seen about murmurs!!!

[@sherelt3101]

Eduardo Moya Que te vaya bien! Stay determined!

[@jennyvalentin5188]

Eduardo Moya. Muy buena suierte. Good luck 🐞

[@herideshernandez6269]

Eduardo Moya, Cómo saliste? Tengo el mío en 4 meses.

[@zwitterionman2359]

Good lecture. Just one correction: Opening snap of Mitral stenosis occurs during diastole and therefore it should come after S2, not S1 as you have depicted in your slide.

[@Zeerr007]

Also both bars in all diagrams are labelled "S1"

[@swarapawar3903]

Thanks a ton, please please keep making more lectures ❤

[@madhukark828]

truly lucky to have access to this

[@gabrieltaggart8841]

You dropped this: 👑

[@yannur6841]

I cannot even begin to thank you!!!! Thats just amazing!!!!

[@manishaprja]

Explained it so well. Thank you so much!

[@herideshernandez6269]

A million of thanks! After all those years I finally understand!

[@barryu4762]

MR.AS(S) = Mitral Reg. Aortic Stenosis -Systole MS.AR(D) = Mitral Sten. Aortic Reg - Diastole

[@ShanilR]

Aortic regurgitation = seen in bicuspid aortic valve OR Aortic root dilation -Pathophysiology = Backflow from aorta into left ventricle -> ↑ LV end-diastolic volume-> eccentric hypertrophy (↑ SV & CO) -> LV dysfunction → decompensated heart failure -C/P = decrescendo early diastolic murmur, widened pulse pressure; Rapid rise-rapid fall ("water-hammer") pulsation (hyperdynamic), Abrupt carotid distension & collapse, "pistol-shot" femoral pulses

[@robynbernard9357]

this was so so helpful! THANK YOU!

[@nasirjan6903]

You made my work so easy by such a phenomenal explanation! Thank you!

[@sfkpathan6677]

Absolutely stunning, Thankyou so much 🎉

[@ludel3539]

The use of two simple mnemonics may help differentiate systolic and diastolic murmurs; PASS and PAID. Pulmonary and aortic stenoses are systolic while pulmonary and aortic insufficiency (regurgitation) are diastolic. Mitral and tricuspid defects are opposite.

[@RamandeepKaur-uq6wm]

This video is such a good review! Thank you so much!

[@omarmaasarji7472]

What amazing easy and fabulous way to learn how murmurs looks like 👍... a silly simple question; what AKA stands for?

[@delightful5165]

I have to like every video even before I watch it because I just know it's going to be good

[@edris.alkozi]

keep up with fantastic work doc

[@mitsukislife]

Wow the maneuvers finally make sense now. Thank you Dirty!!

[@abdu_jilani]

LITERALLY A LIFE SAVER ❤️❤️❤️

[@Dr._Nova_MD]

thanks for the great video! one question -- isn't MVP a regurgitant murmur? In that case, why would it improve with increased afterload, when in general increasing afterload makes regurgitation murmurs worse?

[@nafisadristi493]

Elli Novatcheva I might be wrong, but I think it’s because increased afterload makes ejection of blood during ventricular systole more difficult, as a result blood keeps accumulating in LV and consequently in LA. Too much blood in LA then push the prolapsed mitral valve( which was prolapsed into LA from its original location of AV junction) back to its previous location, thus reducing the murmur. However, more blood in LA means there must’ve been more regurgitation through MVP, so initially the murmur might increase but only till the blood in LA is sufficient enough to push back the prolapsed valve.

[@lauramazzocchitti8509]

murmurs are beautifully explained

[@susanwaweru2734]

Thank you for turning the light bulb on for me.. I just got it.. Mucha gracias, danke schon, asante sana, merci!!!!

[@louisvarre2197]

I enjoy your videos and truly believe you are a gifted educator. However, I think a more accurate description of preload is the volume of blood remaining in the be ventricle prior to filling. I think it’s a more accurate hemodynamic definition. Especially in regards to Starling’s Law.

[@anjanas.krishnan8763]

Awesome videos and explanation sir

[@SanguineMedical]

I think it is the easiest to remember that aortic stenosis is systolic. From there, you know that the counterpart stenosis is systolic too (pulmonary stenosis is systolic), and that opposite valve's opposite problems are systolic too (mitral & tricuspid regurgitation are systolic). For the rest of the murmors, it is the opposite of what I just said. E.g., mitral stenosis is diastolic as mitral regurgitation is systolic. I hope it helps:)

[@سهيالفرجابي]

I can't even thank u enough for this amazing video..lts really very helpful ❤

[@idkyayyyyyy]

Bundle of thanks for sharing these amazing videos...

[@LinhNguyen-zu9jb]

oh my god! I love your videos and all the tricks that you teach us. You are amazing!

[@金子裕介-g7n]

I heard that the points of hearing heart murmur are(1) regions of sounds(A valve? M Valve? Or?)(2) During diastolic or systolic(3)In special case like MVP, key word or key sounds like click sound. Do you think that it is a good strategy? Or, are there any points to rectify?

[@educationaccount3799]

in addition to HOCM and MCP, apparently atrial myxomas have the same effect ... learned this from an NBME exam.

[@mamtakondra]

U r awesome...murmers have been my weakness...i am finally confident i can get them rgt frm now...thankyouuuu somuchhhhh

[@notyourtypicalmidwife9545]

Thank you so much for putting your time, dedication and brains into making this video. So useful!!

[@vadimbelinschi2390]

way i remember is that Semilunar valves (aortic and pulmonic) Stenosis in Systoly from there you can derive the rest

[@suhelafaiz1738]

i had learnt Aortic Stenosis and Pulmonary Stenosis are Systolic with the mnemonic AS-S and PuS-Sy ! that way i know MS is not systolic but diastolic !

[@sagarjigar]

Lol! One hell of a Mnemonic.

[@kollierobert62]

@@sagarjigar up

[@terrim1153]

🤣

[@AlexandraAle2011]

You made it look so easy! Thank you. Very useful ❤

[@walkerrobison4676]

To win MVP, your team has to click with the crazy chick

[@amirite3588]

To win MVP your team has to click and myx with the crazy chick

[@saraghani5963]

Vvvvvv'vvvvvvvvvvvvvvvv

[@teeyinka6957]

thank you so much- just seeing this video and it has helped me !!

[@kaath08]

Thank youu!! the best mnemonics so far!

[@allexyssbrown1147]

YOU ARE INCREDIBLE!!!! THANK YOU SO MUCH!

[@OtoroSabahe]

It’s a treasure Channel❤❤❤

[@khalilsalma9385]

Thanks a lot for this high quality video!

[@priyankaparajuli7508]

Anyway you could do a heart embryology video? :) (Septum primum and what not ahhh) Thanks for making these videos!!!

[@asmsourav3418]

Thank you very much.. It was very helpful...

[@md3170]

THANK YOU SO MUCH YOU SAVE MY LIFE!!!!!!! I FINALLY UNDERSTAND

[@PowderChaser]

You know Dirty, you da real MVP!!!!!

[@KeelyMCraig]

Fantastic explanation -- so obvious now how to determine which murmurs are systolic/diastolic now. Big "oh God duh" movement

[@saritaw4739]

Amazing video! hope you continue to post new ones!

[@mackes3683]

Very helpful video, thanks!

[@ItsMe-xt1bi]

Your mnemonic game is pretty sick bro.

[@chinitodindo]

Thank you Dirty USMLE for this nice video presentation. As you've mentioned at the end part of MVP and something in relation to "younger women w/ psychiatric disorder" which is hard to understand why,then i began thinking about "if it has something to do during spontaneous delivery as they trying to push more harder until the baby comes out?" Because it was mentioned "younger woman and not man."

[@DirtyMedicine]

yes, the association is with young women with psychiatric histories. we don't really know why. your explanation seems plausible at first but even when women have never been pregnant or "pushed" they can still have MVP w/ co-morbid psychiatric illness, so I don't know

[@profgaliba]

Opening snap should be after S2 but it writes S1 on the relevant slide. By the way thank you for the brilliant job

[@sherelt3101]

Another amazing video. Thank you so much!