I think you got that paradoxical split of s2 wrong,,,it has nothing to do with inspiration and delayed emptying of right ventricle leading to renormalising of a2p2 order as you mentioned...I checked 3 or 4 resources, paradoxical s2 is just reversal of s2 split leading to p2a2 aka reversal of s2... it's paradoxical because in a normal patient and in less severe aortic stenosis you get normal a2 p2 order but in severe cases you get paradoxical,p2a2 order .
Dirty, bro I have been listening to your channel for a couple of years and I can honestly say your explanations are the concise and direct . No bullshit just high yield pearls that show up on exams. Dude you should be teaching cause you explain in ways that the facts stick in the mind for years. I can honestly say that most of the stuff in your videos has either helped me or I’ve learnt it thanks to you. Your videos should be taught in medical schools but they would never do that . I passed my step 1 bc of God and much of the material you taught. Thanks again bro and God bless.
Absolutely the best lecture I've ever had on heart sounds and murmurs! You sir are a Godsend 🙌🏾Thank you for this. Taking Step 1 in three weeks so this dropped at the right time
Hi Dirty! Got my step 1 results today (9/8) and I killed it!! I can’t thank you enough. I told myself over and over again that I would become a member as soon as I get my results, and here I am today. Owing it to you. Can’t thank you enough. Proud to be a member. :)
Honestly all of them!!! Especially biochemistry and ethics/psych. I incorporated 10 videos a day during prep and would just rewatch and rewatch all of them. I rewatched everything a week before the exam. Good luck!
This is so beautifully taught 💙 Thank you so much. From the visuals, the color-coding, the helpful mnemonics, and the amazing explanation of the pathophysiology--Masterfully done! Don't worry about the "long-winded" explanations bits, they're way easier to understand than the walls of paragraphs in textbooks. You're helping so many students enter the medical field for the service of others 🙏
One of the most comprehensive and high quality lecture on heart sounds, with clarity and precision .. I am your solid fan Doc… I can absolutely nail it after learning from you .. Giant thanks to all your efforts
Correction: 28:00 angina is due to less blood going into coronary arteries. Opening of coronary arteries in aorta is just above aortic valve so less blood coming in aorta= less blood in coronary and this might lead to angina
Hey I’m really grateful for your videos, they helped me clear MRCP part 1 and 2, with absolutely no other guidance except one other textbook. God Bless
Found this mnemonic somewhere else, in the comment section by Parker Greider. hope this helps :) "(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)
Great video, amazing explanations. I just wish the sound recording would play longer for the ear to get used to it, while looking at the visual depiction. Getting used to what murmurs sound like is difficult. It's understandable at first and it all makes sense up until there is no explanations in front of you and there is only the question vignette and the sound. I also wish there was like a game at the end where you'd play a sound without giving any hints and later on give the answer. It would be a great summary of the material just learned and for STEP takers it would be an amazing practice tool.
This video was so bloody amazing like thank you to the moon to venus to saturn to the next galaxy. You explain things so damn well and I TRULY cannot thank you enough. I recommend your channel to literally everyone of my friends cause you're such a godsend. Thanks for everything you do, and i really love your videos so much. Positive rant over :) Thanks again dirty!
This video is AMAZING! No need to memorize the murmur (I tried for years) just know the pathophys and landmarks plus nmeumonics => all set!! thank you.
Brilliant video. All you need to know about heart sounds and murmurs. Superior to any other resource out there. Thank you, Dirty Dude. Your work is appreciated.
Awesome timing, I'm in my dedicated and today's my cardio day. I was looking for ur older video and this pops up! Can u please make a video on iron,TIBC,ferritin, transferrin values?
I think to differentiate between Tricuspid regurg from Mitral regurg other than where you put the stethoscope is inspiration. When the patient inspire, more venous return occurs on the right-side of the heart, which means more blood is available to regurgitate to the tricuspid valve, thus accentuate the murmur (Carvallo sign). And inspiration will decrease venous return to the left-side of the heart, which decrease the mitral regurg murmur.
This is why I'm on youtube as an aspiring EMT->Paramedic student, stethoscope in hand, with an apparent atrial flutter trying to make sure what is and isn't abnormal and when to be sure of it.
Another way to make sense of paradoxical splitting is to remember that inspiration makes P2 further away from S1. Normally P2 getting further away from S1 also means getting further away from A2. But if A2 is happening second then the opposite occurs.
the most tricky thing about Aortic Regur is that it can also be detected at the left sternal border. This totally threw me off 'cause I was relying on auscultation locations in order to eliminate answer choices
Thank you so much man!!. You are the best. Needed just this cause I have a class tomorrow on splitting sounds and this helped a lot. If it isn't too much, would it be possible to get some audio files on splitting?
@DirtyMedicine I think you got that paradoxical split of s2 wrong,,,it has nothing to do with inspiration and delayed emptying of right ventricle leading to renormalising of a2p2 order as you mentioned...I checked 3 or 4 resources, paradoxical s2 is just reversal of s2 split leading to p2a2 aka reversal of s2... it's paradoxical because in less severe aortic stenosis you get normal a2 p2 order but in severe cases you get paradoxical,p2a2 order .
Young patient right here (29) with moderate aortic stenosis... and no bicuspid or unicuspid valve. 🤷🏼♀️ I have calcification. My murmur is quite subtle, my GP missed it at first, then she heard it when she checked again.. had another dr confirm it's presence, and I could hear it myself as well (student nurse).
I was dealing with the splitting concept as an info to memorize, although it was explained in the lecture but as you said it’s an awful explanation So thanks a lot for this, please give us more wonderful videos The Medical field is in need of you
Out of curiosity is there a reason why you don't use a visible mouse or pointer on your slides? There are certain points where it feels like you're pointing something out on the page but nothing can be seen on the recording. Thx for everything btw
Hey bro! Great work on the video. Is there a video where you table all these murmurs data into a table? Kinda like you do in other videos - transplant rejection video for example where you tabled everything including the mnemonics into one video?
Sir, I have a question. When direct valve is a detected by X-Ray or indeginious substantial methods. Are there alternative ways to simultaneously exhaust... By writing a... While enumerated... I mean supplements are to be provided for heart valve surgery necessity is my point of view unless it is emer... The reason supplements to enh.....
*Correction:* chordae TENDINAE (not "tympani" lol)
Lol
Hypertrophic cardiomyopathy murmur?
@@uworldnotesandconcepts2994 S4, systolic murmur. Increased with valsava.
My local timpanist banged his head and got a nasty percussion.
I think you got that paradoxical split of s2 wrong,,,it has nothing to do with inspiration and delayed emptying of right ventricle leading to renormalising of a2p2 order as you mentioned...I checked 3 or 4 resources, paradoxical s2 is just reversal of s2 split leading to p2a2 aka reversal of s2... it's paradoxical because in a normal patient and in less severe aortic stenosis you get normal a2 p2 order but in severe cases you get paradoxical,p2a2 order .
Just wanna listen how the murmurs sound like?
AS 31:54
MR / TR 35:42
MVP 41:29
VSD 45:41
AR 53:20
MS 57:59
Thanks
Tysm
you are the best
Tysm so handy
Alright so I'm hope you're able to appreciate...
honestly the clearest explanation of a physiology concept I've ever heard in my life. your videos are masterpieces. bless
AS 31:54
MR / TR 35:42
MVP 41:29
VSD 45:41
AR 53:20
MS 57:59
Dirty, bro I have been listening to your channel for a couple of years and I can honestly say your explanations are the concise and direct . No bullshit just high yield pearls that show up on exams. Dude you should be teaching cause you explain in ways that the facts stick in the mind for years.
I can honestly say that most of the stuff in your videos has either helped me or I’ve learnt it thanks to you. Your videos should be taught in medical schools but they would never do that . I passed my step 1 bc of God and much of the material you taught. Thanks again bro and God bless.
Absolutely the best lecture I've ever had on heart sounds and murmurs! You sir are a Godsend 🙌🏾Thank you for this. Taking Step 1 in three weeks so this dropped at the right time
I hope you have passed the exam?
When I’m not a broke med student and start earning, you’re the first person I’m going to donate
This video is a literal masterpiece. Thank you so much for making this so clear.
Hi Dirty!
Got my step 1 results today (9/8) and I killed it!! I can’t thank you enough.
I told myself over and over again that I would become a member as soon as I get my results, and here I am today. Owing it to you. Can’t thank you enough.
Proud to be a member. :)
Congratulations. Which videos did you find the most helpful?
Honestly all of them!!! Especially biochemistry and ethics/psych. I incorporated 10 videos a day during prep and would just rewatch and rewatch all of them. I rewatched everything a week before the exam. Good luck!
This is so beautifully taught 💙 Thank you so much. From the visuals, the color-coding, the helpful mnemonics, and the amazing explanation of the pathophysiology--Masterfully done! Don't worry about the "long-winded" explanations bits, they're way easier to understand than the walls of paragraphs in textbooks. You're helping so many students enter the medical field for the service of others 🙏
One of the most comprehensive and high quality lecture on heart sounds, with clarity and precision ..
I am your solid fan Doc…
I can absolutely nail it after learning from you ..
Giant thanks to all your efforts
Correction: 28:00 angina is due to less blood going into coronary arteries. Opening of coronary arteries in aorta is just above aortic valve so less blood coming in aorta= less blood in coronary and this might lead to angina
Im a junior doctor giving my royal college exams and this video is just what I needed for some last minute revision! can't thank you enough
Huh, sick timing. Was just looking for something like this.
me too! imagine how i excited i was when Dirty announced this in his IG! 😊
needed a refresher, literally sitting at my clinic rotations for Medicine and watching this, so helpful!
Hey I’m really grateful for your videos, they helped me clear MRCP part 1 and 2, with absolutely no other guidance except one other textbook. God Bless
I am in nurse practitioner school and this is the BEST video, thank you so so much, this will be so helpful for the licensing exam!
This video is so well explained and precised!!! Best video on this topic.
Found this mnemonic somewhere else, in the comment section
by Parker Greider.
hope this helps :)
"(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)
Thank you Riteesh!! appreciate it
thank you
One of the best lectures and explanations on this subject
Great video, amazing explanations. I just wish the sound recording would play longer for the ear to get used to it, while looking at the visual depiction. Getting used to what murmurs sound like is difficult. It's understandable at first and it all makes sense up until there is no explanations in front of you and there is only the question vignette and the sound. I also wish there was like a game at the end where you'd play a sound without giving any hints and later on give the answer. It would be a great summary of the material just learned and for STEP takers it would be an amazing practice tool.
This video was so bloody amazing like thank you to the moon to venus to saturn to the next galaxy. You explain things so damn well and I TRULY cannot thank you enough. I recommend your channel to literally everyone of my friends cause you're such a godsend. Thanks for everything you do, and i really love your videos so much. Positive rant over :) Thanks again dirty!
Simply superb!
Hats off to you Sir!🙋♂️🙏🙏🙏👍👍👍
THE BEST video on heart murmurs !!! you are a wizard 🪄
I really appreciate the time and effort you take to make your presentations and help us on our USMLE journey. Thank you :)
Most informative video on heart sounds that I've come across :)
This video is AMAZING! No need to memorize the murmur (I tried for years) just know the pathophys and landmarks plus nmeumonics => all set!! thank you.
This video helped me tremendously, thank you for taking your time to make it!
Brilliant video. All you need to know about heart sounds and murmurs. Superior to any other resource out there. Thank you, Dirty Dude. Your work is appreciated.
Comprehensive, relevant and nicely explained ! Thanks a lot
This is the best video on heart sound that i’ve ever heard
this is incredable lecture !!! youtube university is the the best university !!! millions thanks now i understand everything about heart easly
Awesome timing, I'm in my dedicated and today's my cardio day. I was looking for ur older video and this pops up!
Can u please make a video on iron,TIBC,ferritin, transferrin values?
What a great video. You explain so well that it's easy to understand. Thank you
Thank you so much for sharing. Took me 2 hours but totally worth it
lmk if you ever need a kidney
The best lecture on heart sounds on youtube❤
Omg I'm literally watching a premiere video of yours! awesome!!!!
I think to differentiate between Tricuspid regurg from Mitral regurg other than where you put the stethoscope is inspiration. When the patient inspire, more venous return occurs on the right-side of the heart, which means more blood is available to regurgitate to the tricuspid valve, thus accentuate the murmur (Carvallo sign). And inspiration will decrease venous return to the left-side of the heart, which decrease the mitral regurg murmur.
great tip
Thank you so much for your videos, they're amazing! You're definitely helping me get through med school!
thank you so much. you are the best teacher on youtube.
Really appreciate your work and your efforts that you put in this video to make it easier to understand.
I came to the 26th minute and come to the comment section to tell you how amaizing you are.Thank you so much
This is why I'm on youtube as an aspiring EMT->Paramedic student, stethoscope in hand, with an apparent atrial flutter trying to make sure what is and isn't abnormal and when to be sure of it.
this is GOLD 🏅 i was just looking for this type of content, and a week after, Dirty announced it on IG. woot!
GOLD! this video has saved me time and time again !
Excellent video ❤️....no words....ur a genuine saviour...!🙏🏻
Amazing, the clouds have parted! Thank you!
That was so nice and clear. Thanks to your teaching💯
Very good lecture, you went straight to the heart of the subject. ❤️
Another way to make sense of paradoxical splitting is to remember that inspiration makes P2 further away from S1. Normally P2 getting further away from S1 also means getting further away from A2. But if A2 is happening second then the opposite occurs.
Perfect timing, thank you
you make heart sounds better than a heart does lol
Perfect timing!
was hoping you uploaded a new murmur video, and BAM here it is :0
Perfect!! I’m so excited to watch this
i know this will be best video for those students who search for heart murmurs
This is sterling work. Chefs kisses.
Cannot thank you enough. I was going to leave this topic. THANK YOU!!!
please make more videos on embryology! these are very helpful
Thank you so much. I watched the whole cardio videos that you made. Thanks again.🍉
This is amazing! Just wish we had a bit more time with the heart sounds.
Perfect timing either here!
the most tricky thing about Aortic Regur is that it can also be detected at the left sternal border. This totally threw me off 'cause I was relying on auscultation locations in order to eliminate answer choices
Your explanations and the way you Spoke were so clear ..precised. And well organized...congrats.!
Thank you, you did explaining the wide splitting thing so well!
So good no one explain it like this
Thank you so much 👌👌👌😍😍😍😍😍
i wasnt paying attention to the video but its good bg noise so nice
bookmark: 35:40 - mitral/tricuspid regurgitation sound
Good stuff. I was just about to review my cardiology.
That's outstanding illustration ♥️
This is gonna be a Blastttt!!
Thank you so much man!!. You are the best. Needed just this cause I have a class tomorrow on splitting sounds and this helped a lot. If it isn't too much, would it be possible to get some audio files on splitting?
@DirtyMedicine I think you got that paradoxical split of s2 wrong,,,it has nothing to do with inspiration and delayed emptying of right ventricle leading to renormalising of a2p2 order as you mentioned...I checked 3 or 4 resources, paradoxical s2 is just reversal of s2 split leading to p2a2 aka reversal of s2... it's paradoxical because in less severe aortic stenosis you get normal a2 p2 order but in severe cases you get paradoxical,p2a2 order .
This ...is bloody brilliant!!
Young patient right here (29) with moderate aortic stenosis... and no bicuspid or unicuspid valve. 🤷🏼♀️ I have calcification.
My murmur is quite subtle, my GP missed it at first, then she heard it when she checked again.. had another dr confirm it's presence, and I could hear it myself as well (student nurse).
may alllah heal you brother
thank you so much for making this video!
I was dealing with the splitting concept as an info to memorize, although it was explained in the lecture but as you said it’s an awful explanation
So thanks a lot for this, please give us more wonderful videos
The Medical field is in need of you
Dr Dirty, you are good o. It's amazing
7:05
31:55
35:42
41:29
45:41
53:20
57:59
The GOAT video. Thanks Dirty!
35:42 - mitral/tricuspid regurgitation sound ... (my bookmark).
Out of curiosity is there a reason why you don't use a visible mouse or pointer on your slides? There are certain points where it feels like you're pointing something out on the page but nothing can be seen on the recording. Thx for everything btw
The best doctor in the world 😘
Plz also explain the heart sounds question for step 1
my personal memory tip btw for MVP...click as in remote control to watch the game :)
Taking exam in the morning. Need this now. Lol.
Thanks for everything!
Have my cardio final next week. This was clutch
ive never fully understood what P2 and A2 were and visual depiction of murmurs until i found your video
Masterpiece, thanks a lot
Hey bro! Great work on the video. Is there a video where you table all these murmurs data into a table? Kinda like you do in other videos - transplant rejection video for example where you tabled everything including the mnemonics into one video?
Best explanation!
Thank u very much sir ❤️ like u just saved my life :")
Watching this vedio before my neet pg exam which is entrance exam for residency training in India thank you dirty. Thank you 🙏
very powerful and great explanation ... thank you
Thankyou so so much sir, We are indebted to you. This was a much needed topic
Sir, I have a question. When direct valve is a detected by X-Ray or indeginious substantial methods. Are there alternative ways to simultaneously exhaust... By writing a... While enumerated... I mean supplements are to be provided for heart valve surgery necessity is my point of view unless it is emer... The reason supplements to enh.....
that was an excellent explanation thank you so much
does dirty medicine has all the HY concepts videos made ?
Many of them, yes. Check the channel!
Clean explanation, thank you ~