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
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
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🙏
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)
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!
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.
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!
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.
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.
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.
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.
When medical students across borders were in distress .....but in desperation to understand concepts.....GOD CREATED DIRTY USMLE FOR THEIR SAVIOUR ❣️❣️❣️❣️❣️
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!!!
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.
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!
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
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.
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!
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 .
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.
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!!!
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
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 ..
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 !
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.
This is absolutely genius 👏 🙌 you literally not only save our career but the lives of our fure patients also ❤❤❤❤❤❤ thank youuuuuuuuuuuuuuuuuuu ❤❤❤❤❤❤❤❤❤❤❤
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?
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.
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?
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:)
my mnemonic for systolic murmurs: youTubeRs doing ASMR are whispering youTubeR for TR ASMR for AS and MR whispering for PS (like when you finish off a secret letter)
Do the maneuvers actually make the MVP louder or softer or are they affecting the timing of the midsystolic click (early vs later click), or are both volume and timing being affected?
I read MVP is the most common congenital heart valve abnormality, but is under diagnosed because asymptomatic. During times of rest, patient starting feeling SOB, which through psychogenic positive feedback worsen the V/Q mismatch leading to panic attacks. What your option this theory?
Dear dirty!! I really want to thank you for all your recommendations!! And all your videos!!! You are such a great teacher...I wish I could have money to pay you, but I don't lol..THANK YOU SO MUCH..God bless you 🤗
