Congenital Abnormalities

Coarctation of the Aorta Auscultation Lesson with Recordings

Virtual Auscultation

patient torso with stethoscope chestpiece

The patient's position is sitting leaning forward.

Lesson

This is an example of coarctation of the aorta, a congenital abnormality. This first heart sound is normal. The second heart sound is intensified. There is diamond shaped murmur occupying most of systole and a high-pitched decrescendo murmur in the first half of diastole. In the anatomy video you can see a constriction in the descending aorta which is responsible for the systolic murmur. There is regurgitant flow from the aorta into the left ventricle which causes the diastolic murmur. The left ventricle wall thickness is increased due to aortic pressure elevation caused by the aortic coarctation.

Waveform

Heart Sounds Video

Play the cardiac movie and observe a constriction in the descending aorta which is responsible for the systolic murmur. There is regurgitant flow from the aorta into the left ventricle which causes the diastolic murmur. The left ventricle wall thickness is increased due to aortic pressure elevation caused by the aortic coarctation.

Authors and Sources

Authors and Reviewers

Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
Lung sounds by Diane Wrigley, PA
Respiratory cases: William French
David Lieberman, Audio Engineering
Heart sounds mentorship by W. Proctor Harvey, MD
Special thanks for the medical mentorship of Dr. Raymond Murphy
Reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
Last Update: 12/11/2022

Sources

Heart and Lung Sounds Reference Library Diane S. Wrigley
Publisher: PESI
Impact Patient Care: Key Physical Assessment Strategies and the Underlying Pathophysiology
Diane S Wrigley & Rosale Lobo
Practical Clinical Skills: Lung Sounds
Essential Lung Sounds Diane S. Wrigley, PA-C
Published by MedEdu LLC
PESI Faculty - Diane S Wrigley
Case Profiles in Respiratory Care 3rd Ed, 2019
William A.French
Published by Delmar Cengage
Essential Lung Sounds by William A. French
Published by Cengage Learning, 2011
Understanding Lung Sounds Steven Lehrer, MD
Clinical Heart Disease W Proctor Harvey, MD
Clinical Heart Disease
Laennec Publishing; 1st edition (January 1, 2009)