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 .
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
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.
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!
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
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)
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
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 🙏
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.
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.
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.
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
@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 .
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?
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
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).
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?
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
![[TH] RNT vs SPG - VCT Ascension Pacific - Day 1](http://i.ytimg.com/vi/RUTkf8Detj8/mqdefault.jpg)
*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...
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?
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.
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!
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
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
honestly the clearest explanation of a physiology concept I've ever heard in my life. your videos are masterpieces. bless
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.
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
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 🙏
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! 😊
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!
EXCUSE ME , THIS KNOWLEDGE , BENEFIT & WORK CAN'T BE DIRTY AT ALL .... YOU ARE AWESOME
lmk if you ever need a kidney
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 is so well explained and precised!!! Best video on this topic.
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!🙋♂️🙏🙏🙏👍👍👍
One of the best lectures and explanations on this subject
THE BEST video on heart murmurs !!! you are a wizard 🪄
needed a refresher, literally sitting at my clinic rotations for Medicine and watching this, so helpful!
I really appreciate the time and effort you take to make your presentations and help us on our USMLE journey. Thank you :)
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.
Most informative video on heart sounds that I've come across :)
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.
this is incredable lecture !!! youtube university is the the best university !!! millions thanks now i understand everything about heart easly
Comprehensive, relevant and nicely explained ! Thanks a lot
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.
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?
This is the best video on heart sound that i’ve ever heard
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 sharing. Took me 2 hours but totally worth it
Thank you so much for your videos, they're amazing! You're definitely helping me get through med school!
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.
What a great video. You explain so well that it's easy to understand. Thank you
i know this will be best video for those students who search for heart murmurs
Excellent video ❤️....no words....ur a genuine saviour...!🙏🏻
this is GOLD 🏅 i was just looking for this type of content, and a week after, Dirty announced it on IG. woot!
Omg I'm literally watching a premiere video of yours! awesome!!!!
The best lecture on heart sounds on youtube❤
Really appreciate your work and your efforts that you put in this video to make it easier to understand.
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
Amazing, the clouds have parted! Thank you!
thank you so much. you are the best teacher on youtube.
Cannot thank you enough. I was going to leave this topic. THANK YOU!!!
you make heart sounds better than a heart does lol
Very good lecture, you went straight to the heart of the subject. ❤️
my personal memory tip btw for MVP...click as in remote control to watch the game :)
AS 31:54
MR / TR 35:42
MVP 41:29
VSD 45:41
AR 53:20
MS 57:59
Perfect timing, thank you
GOLD! this video has saved me time and time again !
@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 .
Hello dirtymedicine I've passed my step 1. Tysm for your efforts. ❤️.
That was so nice and clear. Thanks to your teaching💯
This is sterling work. Chefs kisses.
Perfect timing!
Thank you so much. I watched the whole cardio videos that you made. Thanks again.🍉
was hoping you uploaded a new murmur video, and BAM here it is :0
Perfect!! I’m so excited to watch this
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
please make more videos on embryology! these are very helpful
Thank you, you did explaining the wide splitting thing so well!
Perfect timing either here!
Masterpiece, thanks a lot
it is NOT silly i learned many topics in various schools just like that!
ive never fully understood what P2 and A2 were and visual depiction of murmurs until i found your video
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?
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
This is amazing! Just wish we had a bit more time with the heart sounds.
i wasnt paying attention to the video but its good bg noise so nice
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
Taking exam in the morning. Need this now. Lol.
Good stuff. I was just about to review my cardiology.
Have my cardio final next week. This was clutch
Thankyou so so much sir, We are indebted to you. This was a much needed topic
So good no one explain it like this
Thank you so much 👌👌👌😍😍😍😍😍
Thanks for everything!
Thank u very much sir ❤️ like u just saved my life :")
Your explanations and the way you Spoke were so clear ..precised. And well organized...congrats.!
That's outstanding illustration ♥️
This is gonna be a Blastttt!!
Watching this vedio before my neet pg exam which is entrance exam for residency training in India thank you dirty. Thank you 🙏
thank you so much for making this video!
very powerful and great explanation ... thank you
Thanks!
This ...is bloody brilliant!!
The best doctor in the world 😘
Plz also explain the heart sounds question for step 1
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?
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
The GOAT video. Thanks Dirty!
that was an excellent explanation thank you so much
Dr Dirty, you are good o. It's amazing
I was just studying this , this morning! lol. perfect vid
It was just so perfect I loved it 🙏🏻
Thanks so much
Thank you. Seriously..thank you.