A heart murmur is an unusual sound heard between heartbeats. Murmurs sometimes sound like a whooshing or swishing noise. Murmurs may be harmless, also called innocent, or abnormal. Abnormal murmurs may mean a valve isn't working normally. Learn about causes, symptoms, and treatment.
Human Heart Valves
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About
Stethoscope Placement for Auscultation
Image by CNX Openstax
Stethoscope Placement for Auscultation
Proper placement of the bell of the stethoscope facilitates auscultation. At each of the four locations on the chest, a different valve can be heard.
Image by CNX Openstax
What Is a Heart Murmur?
A heart murmur is an unusual sound heard between heartbeats.
Murmurs sometimes sound like a whooshing or swishing noise. Murmurs may be harmless, also called innocent, or abnormal. Harmless murmurs may not cause symptoms and can happen when blood flows more rapidly than normal through the heart such as during exercise, pregnancy, or rapid growth in children. Abnormal murmurs may be a sign of a more serious heart condition, such as a congenital heart defect that is present since birth or heart valve disease. Depending on the heart problem causing the abnormal murmurs, the murmurs may be associated with other symptoms such as shortness of breath, dizziness or fainting, bluish skin, or a chronic cough.
If a heart murmur is detected, your doctor will listen to the loudness, location and timing of your murmur to find out whether it is harmless or a sign of a more serious condition. If your doctor thinks you may have a more serious condition, your doctor may refer you to a cardiologist, or a doctor who specializes in the heart. The cardiologist may have you do other tests such as an electrocardiogram (EKG) or echocardiogram to look for heart rhythm or structural problems and see how well your heart is working.
A heart murmur itself does not require treatment. If it is caused by a more serious heart condition, your doctor may recommend treatment for that heart condition. Treatment may include medicines, cardiac catheterization, or surgery. The outlook and treatment for abnormal heart murmurs depend on the type and severity of the heart condition that is causing the murmur.
Source: National Heart, Lung, and Blood Institute (NHLBI)
What is a Heart Murmur and How Does it Relate to Valve Problems?
American Heart Association/YouTube
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Holosystolic Murmur - Heart Sounds - MEDZCOOL
Medzcool/YouTube
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What is a Heart Murmur? - Nemours Answers to Grow On
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Be Heart Smart: What is a heart murmur?
Carilion Clinic/YouTube
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Heart murmur sounds (cardiac auscultation sounds)
Geeky Medics/YouTube
0:51
What is a heart murmur and what can cause it?
Mount Sinai Health System/YouTube
1:15
If my child's heart murmur is innocent, what does that mean for them?
Mount Sinai Health System/YouTube
0:25
Is a heart murmur serious in adults?
Medical City Dallas/YouTube
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Systolic murmurs, diastolic murmurs, and extra heart sounds - Part 1 | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
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Systolic murmurs, diastolic murmurs, and extra heart sounds - Part 2 | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
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Pediatric Heart Murmur with Dr. Nita Doshi | Pediatric Cardiology | CHOC
CHOC Children's/YouTube
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Valve Regurgitation: When a Heart Valve Leaks
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Mitral Valve Prolapse - Heart Sounds - MEDZCOOL
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Heart Murmurs
Strong Medicine/YouTube
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S4 Heart Sound - MEDZCOOL
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Split S1 - Heart Sounds - MEDZCOOL
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Fixed Split S2 - Heart Sounds - MEDZCOOL
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Atrial Septal Defect - Heart Sounds - MEDZCOOL
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Understanding Heart Valves and the Four Systems in the Heart
American Heart Association/YouTube
How the Heart Works
EKG and human heart illustration
Image by U.S. Food and Drug Administration (FDA)
EKG and human heart illustration
Cardiovascular devices (or 'heart' devices) such as pacemakers and defibrillators have extended and improved the lives of millions of people worldwide. Learn how the FDA regulates these devices, when to seek medical attention for potential heart issues, and how to report problems.
Image by U.S. Food and Drug Administration (FDA)
Heart Murmur - How the Heart Works
The heart is a muscle about the size of your fist. It works like a pump and beats 100,000 times a day.
The heart has two sides, separated by an inner wall called the septum. The right side of the heart pumps blood to the lungs to pick up oxygen. The left side of the heart receives the oxygen-rich blood from the lungs and pumps it to the body.
The heart has four chambers and four valves and is connected to various blood vessels. Veins are blood vessels that carry blood from the body to the heart. Arteries are blood vessels that carry blood away from the heart to the body.
A Healthy Heart Cross-Section
Figure 1 shows the location of the heart in the body. Figure B shows a cross-section of a healthy heart and its inside structures. The blue arrow shows the direction in which oxygen-poor blood flows through the heart to the lungs. The red arrow shows the direction in which oxygen-rich blood flows from the lungs into the heart and then out to the body.
Heart Chambers
The heart has four chambers or "rooms."
The atria (AY-tree-uh) are the two upper chambers that collect blood as it flows into the heart.
The ventricles (VEN-trih-kuls) are the two lower chambers that pump blood out of the heart to the lungs or other parts of the body.
Heart Valves
Four valves control the flow of blood from the atria to the ventricles and from the ventricles into the two large arteries connected to the heart.
The tricuspid (tri-CUSS-pid) valve is in the right side of the heart, between the right atrium and the right ventricle.
The pulmonary (PULL-mun-ary) valve is in the right side of the heart, between the right ventricle and the entrance to the pulmonary artery. The artery carries blood from the heart to the lungs.
The mitral (MI-trul) valve is in the left side of the heart, between the left atrium and the left ventricle.
The aortic (ay-OR-tik) valve is in the left side of the heart, between the left ventricle and the entrance to the aorta. This artery carries blood from the heart to the body.
Valves are like doors that open and close. They open to allow blood to flow through to the next chamber or to one of the arteries. Then they shut to keep blood from flowing backward.
When the heart's valves open and close, they make a "lub-DUB" sound that a doctor can hear using a stethoscope.
The first sound—the "lub"—is made by the mitral and tricuspid valves closing at the beginning of systole (SIS-toe-lee). Systole is when the ventricles contract, or squeeze, and pump blood out of the heart.
The second sound—the "DUB"—is made by the aortic and pulmonary valves closing at the beginning of diastole (di-AS-toe-lee). Diastole is when the ventricles relax and fill with blood pumped into them by the atria.
Arteries
The arteries are major blood vessels connected to your heart.
The pulmonary artery carries blood from the right side of the heart to the lungs to pick up a fresh supply of oxygen.
The aorta is the main artery that carries oxygen-rich blood from the left side of the heart to the body.
The coronary arteries are the other important arteries attached to the heart. They carry oxygen-rich blood from the aorta to the heart muscle, which must have its own blood supply to function.
Veins
The veins also are major blood vessels connected to your heart.
The pulmonary veins carry oxygen-rich blood from the lungs to the left side of the heart so it can be pumped to the body.
The superior and inferior vena cavae are large veins that carry oxygen-poor blood from the body back to the heart.
Source: National Heart, Lung, and Blood Institute (NHLBI)
Causes
Myocarditis
Image by TheVisualMD
Myocarditis
Inflammatory processes of the muscular walls of the heart (MYOCARDIUM) which result in injury to the cardiac muscle cells (MYOCYTES, CARDIAC). Manifestations range from subclinical to sudden death (DEATH, SUDDEN). Myocarditis in association with cardiac dysfunction is classified as inflammatory CARDIOMYOPATHY usually caused by INFECTION, autoimmune diseases, or responses to toxic substances. Myocarditis is also a common cause of DILATED CARDIOMYOPATHY and other cardiomyopathies. (NCBI/NLM/NIH)
Image by TheVisualMD
What Causes Heart Murmurs?
Innocent Heart Murmurs
Why some people have innocent heart murmurs and others do not isn't known. Innocent murmurs are simply sounds made by blood flowing through the heart's chambers and valves, or through blood vessels near the heart.
Extra blood flow through the heart also may cause innocent heart murmurs. After childhood, the most common cause of extra blood flow through the heart is pregnancy. This is because during pregnancy, women's bodies make extra blood. Most heart murmurs that occur in pregnant women are innocent.
Abnormal Heart Murmurs
Congenital heart defects or acquired heart valve disease often are the cause of abnormal heart murmurs.
Congenital Heart Defects
Congenital heart defects are the most common cause of abnormal heart murmurs in children. These defects are problems with the heart's structure that are present at birth. They change the normal flow of blood through the heart.
Congenital heart defects can involve the interior walls of the heart, the valves inside the heart, or the arteries and veins that carry blood to and from the heart. Some babies are born with more than one heart defect.
Heart valve problems, septal defects (also called holes in the heart), and diseases of the heart muscle such as hypertrophic cardiomyopathy are common heart defects that cause abnormal heart murmurs.
Examples of valve problems are narrow valves that limit blood flow or leaky valves that don't close properly. Septal defects are holes in the wall that separates the right and left sides of the heart. This wall is called the septum.
A hole in the septum between the heart's two upper chambers is called an atrial septal defect. A hole in the septum between the heart's two lower chambers is called a ventricular septal defect.
Hypertrophic (hi-per-TROF-ik) cardiomyopathy (kar-de-o-mi-OP-ah-thee) (HCM) occurs if heart muscle cells enlarge and cause the walls of the ventricles (usually the left ventricle) to thicken. The thickening may block blood flow out of the ventricle. If a blockage occurs, the ventricle must work hard to pump blood to the body. HCM also can affect the heart’s mitral valve, causing blood to leak backward through the valve.
Heart Defects That Can Cause Abnormal Heart Murmurs
Figure A shows the structure and blood flow inside a normal heart. Figure B shows a heart with leaking and narrowed valves. Figure C shows a heart with a ventricular septal defect.
Acquired Heart Valve Disease
Acquired heart valve disease often is the cause of abnormal heart murmurs in adults. This is heart valve disease that develops as the result of another condition.
Many conditions can cause heart valve disease. Examples include heart conditions and other disorders, age-related changes, rheumatic (ru-MAT-ik) fever, and infections.
Heart conditions and other disorders. Certain conditions can stretch and distort the heart valves, such as:
Damage and scar tissue from a heart attack or injury to the heart.
Advanced high blood pressure and heart failure. These conditions can enlarge the heart or its main arteries.
Age-related changes. As you get older, calcium deposits or other deposits may form on your heart valves. These deposits stiffen and thicken the valve flaps and limit blood flow. This stiffening and thickening of the valve is called sclerosis (skle-RO-sis).
Rheumatic fever. The bacteria that cause strep throat, scarlet fever, and, in some cases, impetigo (im-peh-TI-go) also can cause rheumatic fever. This serious illness can develop if you have an untreated or not fully treated streptococcal (strep) infection.
Rheumatic fever can damage and scar the heart valves. The symptoms of this heart valve damage often don't occur until many years after recovery from rheumatic fever.
Today, most people who have strep infections are treated with antibiotics before rheumatic fever develops. It's very important to take all of the antibiotics your doctor prescribes for strep throat, even if you feel better before the medicine is gone.
Infections. Common germs that enter the bloodstream and get carried to the heart can sometimes infect the inner surface of the heart, including the heart valves. This rare but sometimes life-threatening infection is called infective endocarditis (EN-do-kar-DI-tis), or IE.
IE is more likely to develop in people who already have abnormal blood flow through a heart valve because of heart valve disease. The abnormal blood flow causes blood clots to form on the surface of the valve. The blood clots make it easier for germs to attach to and infect the valve.
IE can worsen existing heart valve disease.
Other Causes
Some heart murmurs occur because of an illness outside of the heart. The heart is normal, but an illness or condition can cause blood flow that's faster than normal. Examples of this type of illness include fever, anemia (uh-NEE-me-eh), and hyperthyroidism.
Anemia is a condition in which the body has a lower than normal number of red blood cells. Hyperthyroidism is a condition in which the body has too much thyroid hormone.
Source: National Heart, Lung, and Blood Institute (NHLBI)
Figure A shows the structure and blood flow in the interior of a normal heart. Figure B shows two common locations for a ventricular septal defect. The defect allows oxygen-rich blood from the left ventricle to mix with oxygen-poor blood in the right ventricle.
Depiction of a person suffering from chest pain. The typical causes of chest pain have been mentioned.
Image by https://www.myupchar.com
What Are the Signs and Symptoms of a Heart Murmur?
People who have innocent (harmless) heart murmurs don't have any signs or symptoms other than the murmur itself. This is because innocent heart murmurs aren't caused by heart problems.
People who have abnormal heart murmurs may have signs or symptoms of the heart problems causing the murmurs. These signs and symptoms may include:
Poor eating and failure to grow normally (in infants)
Shortness of breath, which may occur only with physical exertion
Excessive sweating with minimal or no exertion
Chest pain
Dizziness or fainting
A bluish color on the skin, especially on the fingertips and lips
Chronic cough
Swelling or sudden weight gain
Enlarged liver
Enlarged neck veins
Signs and symptoms depend on the problem causing the heart murmur and its severity.
Source: National Heart, Lung, and Blood Institute (NHLBI)
Additional Materials (2)
Are Vaccinations safe?
Video by Baby Care 101/YouTube
Nail clubbing
Congenital Heart Case : Digital clubbing with cyanotic nail beds in an otherwise healthy-appearing, asymptomatic young adult is characteristic of a congenital cardiac anomaly with right-to-left shunting. The patient shown had tetralogy of Fallot, the most common congenital cyanotic heart disease in adults.
Image by Herbert L. Fred, MD and Hendrik A. van Dijk
2:01
Are Vaccinations safe?
Baby Care 101/YouTube
Nail clubbing
Herbert L. Fred, MD and Hendrik A. van Dijk
Diagnosis
Heart Function (EKG)
Image by TheVisualMD
Heart Function (EKG)
Electrocardiography - Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY. (NCBI/NLM/NIH)
Image by TheVisualMD
How Is a Heart Murmur Diagnosed?
Doctors use a stethoscope to listen to heart sounds and hear heart murmurs. They may detect heart murmurs during routine checkups or while checking for another condition.
If a congenital heart defect causes a murmur, it's often heard at birth or during infancy. Abnormal heart murmurs caused by other heart problems can be heard in patients of any age.
Specialists Involved
Primary care doctors usually refer people who have abnormal heart murmurs to cardiologists or pediatric cardiologists for further care and testing.
Cardiologists are doctors who specialize in diagnosing and treating heart problems in adults. Pediatric cardiologists specialize in diagnosing and treating heart problems in children.
Physical Exam
Your doctor will carefully listen to your heart or your child's heart with a stethoscope to find out whether a murmur is innocent or abnormal. He or she will listen to the loudness, location, and timing of the murmur. This will help your doctor diagnose the cause of the murmur.
Your doctor also may:
Ask about your medical and family histories.
Do a complete physical exam. He or she will look for signs of illness or physical problems. For example, your doctor may look for a bluish color on your skin. In infants, doctors may look for delayed growth and feeding problems.
Ask about your symptoms, such as chest pain, shortness of breath (especially with physical exertion), dizziness, or fainting.
Evaluating Heart Murmurs
When evaluating a heart murmur, your doctor will pay attention to many things, such as:
How faint or loud the sound is. Your doctor will grade the murmur on a scale of 1 to 6 (1 is very faint and 6 is very loud).
When the sound occurs in the cycle of the heartbeat.
Where the sound is heard in the chest and whether it also can be heard in the neck or back.
Whether the sound has a high, medium, or low pitch.
How long the sound lasts.
How breathing, physical activity, or a change in body position affects the sound.
Diagnostic Tests and Procedures
If your doctor thinks you or your child has an abnormal heart murmur, he or she may recommend one or more of the following tests.
Chest X Ray
A chest x ray is a painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. This test is done to find the cause of symptoms, such as shortness of breath and chest pain.
EKG
An EKG (electrocardiogram) is a simple test that detects and records the heart's electrical activity. An EKG shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through each part of the heart.
This test is used to detect and locate the source of heart problems. The results from an EKG also may be used to rule out certain heart problems.
Echocardiography
Echocardiography (EK-o-kar-de-OG-ra-fee), or echo, is a painless test that uses sound waves to create pictures of your heart. The test shows the size and shape of your heart and how well your heart's chambers and valves are working.
Echo also can show areas of poor blood flow to the heart, areas of heart muscle that aren't contracting normally, and previous injury to the heart muscle caused by poor blood flow.
There are several types of echo, including a stress echo. This test is done both before and after a stress test. During this test, you exercise to make your heart work hard and beat fast. If you can’t exercise, you may be given medicine to make your heart work hard and beat fast. Echo is used to take pictures of your heart before you exercise and as soon as you finish.
Stress echo shows whether you have decreased blood flow to your heart (a sign of coronary heart disease).
Source: National Heart, Lung, and Blood Institute (NHLBI)
Additional Materials (3)
What is a Heart Murmur and How Does it Relate to Valve Problems?
Video by American Heart Association/YouTube
Be Heart Smart: What is a heart murmur?
Video by Carilion Clinic/YouTube
Circulatory System of a Human Fetus
Circulation operates differently in the fetus. While a fetus is developing in the womb, the lungs never expand and never collect or contain any air. Oxygenated blood comes directly from the mother through the placenta and umbilical cord. In addition, the path of blood through the fetal heart is different from that of an adult. In the fetus, much of the blood that enters the right side of the heart flows directly into the left side of the heart through a valve called the foramen ovale and back out into the body. The remaining blood that flows into the major vessel to the lungs - the pulmonary artery - is still redirected away from the non-functioning lungs. It moves directly from the pulmonary artery through a pathway called the ductus arteriosis into the major vessel to the rest of the body - the aorta. Although the vessels are in place and the four-chambered heart works, until birth, blood circulating through the fetus bypasses the pulmonary circulation entirely.
Image by TheVisualMD
0:53
What is a Heart Murmur and How Does it Relate to Valve Problems?
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Be Heart Smart: What is a heart murmur?
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Circulatory System of a Human Fetus
TheVisualMD
Chest X-Ray
Chest X-Ray Test
Also called: CXR, Chest X Ray, Chest Radiograph, Chest Radiography, Chest Film
A chest X-ray is an imaging test that uses electromagnetic waves to create pictures of the structures in and around the chest. The test can help diagnose and monitor conditions of the heart, lungs, bones, and chest cavity.
Chest X-Ray Test
Also called: CXR, Chest X Ray, Chest Radiograph, Chest Radiography, Chest Film
A chest X-ray is an imaging test that uses electromagnetic waves to create pictures of the structures in and around the chest. The test can help diagnose and monitor conditions of the heart, lungs, bones, and chest cavity.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
X rays are electromagnetic waves. They use ionizing radiation to create pictures of the inside of your body. A chest x ray takes pictures of the inside of your chest. The different tissues in your chest absorb different amounts of radiation. Your ribs and spine are bony and absorb radiation well. They normally appear light on a chest x ray. Your lungs, which are filled with air, normally appear dark.
Related conditions
A chest x ray is a painless, noninvasive test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. "Noninvasive" means that no surgery is done and no instruments are inserted into your body. This test is done to find the cause of symptoms such as shortness of breath, chest pain, chronic cough (a cough that lasts a long time), and fever.
Chest x rays help doctors diagnose conditions such as pneumonia (nu-MO-ne-ah), heart failure, lung cancer, lung tissue scarring, and sarcoidosis (sar-koy-DO-sis). Doctors also may use chest x rays to see how well treatments for certain conditions are working. Also, doctors often use chest x rays before surgery to look at the structures in the chest.
Chest x rays are the most common x-ray test used to diagnose health problems.
Doctors may recommend chest x rays for people who have symptoms such as shortness of breath, chest pain, chronic cough (a cough that lasts a long time), or fever. The test can help find the cause of these symptoms.
Chest x rays look for conditions such as pneumonia, heart failure, lung cancer, lung tissue scarring, or sarcoidosis. The test also is used to check how well treatments for certain conditions are working.
Chest x rays also are used to evaluate people who test positive for tuberculosis (tu-ber-kyu-LO-sis) exposure on skin tests.
Sometimes, doctors recommend more chest x rays within hours, days, or months of an earlier chest x ray. This allows them to follow up on a condition.
People who are having certain types of surgery also may need chest x rays. Doctors often use the test before surgery to look at the structures inside the chest.
Depending on your doctor's request, you'll stand, sit, or lie for the chest x ray. The technician will help position you correctly. He or she may cover you with a heavy lead apron to protect certain parts of your body from the radiation.
The x-ray equipment usually consists of two parts. One part, a box-like machine, holds the x-ray film or a special plate that records the picture digitally. You'll sit or stand next to this machine. The second part is the x-ray tube, which is located about 6 feet away.
Before the pictures are taken, the technician will walk behind a wall or into the next room to turn on the x-ray machine. This helps reduce his or her exposure to the radiation.
Usually, two views of the chest are taken. The first is a view from the back. The second is a view from the side.
For a view from the back, you'll sit or stand so that your chest rests against the image plate. The x-ray tube will be behind you. For the side view, you'll turn to your side and raise your arms above your head.
If you need to lie down for the test, you'll lie on a table that contains the x-ray film or plate. The x-ray tube will be over the table.
You'll need to hold very still while the pictures are taken. The technician may ask you to hold your breath for a few seconds. These steps help prevent a blurry picture.
Although the test is painless, you may feel some discomfort from the coolness of the exam room and the x-ray plate. If you have arthritis or injuries to the chest wall, shoulders, or arms, you may feel discomfort holding a position during the test. The technician may be able to help you find a more comfortable position.
When the test is done, you'll need to wait while the technician checks the quality of the x-ray pictures. He or she needs to make sure that the pictures are good enough for the doctor to use.
You don't have to do anything special to prepare for a chest x ray. However, you may want to wear a shirt that's easy to take off. Before the test, you'll be asked to undress from the waist up and wear a gown.
You also may want to avoid wearing jewelry and other metal objects. You'll be asked to take off any jewelry, eyeglasses, and metal objects that might interfere with the x-ray picture. Let the x-ray technician (a person specially trained to do x-ray tests) know if you have any body piercings on your chest.
Let your doctor know if you're pregnant or may be pregnant. In general, women should avoid all x-ray tests during pregnancy. Sometimes, though, having an x ray is important to the health of the mother and fetus. If an x ray is needed, the technician will take extra steps to protect the fetus from radiation.
Chest x rays have few risks. The amount of radiation used in a chest x ray is very small. A lead apron may be used to protect certain parts of your body from the radiation.
The test gives out a radiation dose similar to the amount of radiation you're naturally exposed to over 10 days.
Chest x rays show the structures in and around the chest. The test is used to look for and track conditions of the heart, lungs, bones, and chest cavity. For example, chest x-ray pictures may show signs of pneumonia, heart failure, lung cancer, lung tissue scarring, or sarcoidosis.
Chest x rays do have limits. They only show conditions that change the size of tissues in the chest or how the tissues absorb radiation. Also, chest x rays create two-dimensional pictures. This means that denser structures, like bone or the heart, may hide some signs of disease. Very small areas of cancer and blood clots in the lungs usually don't show up on chest x rays.
For these reasons, your doctor may recommend other tests to confirm a diagnosis.
https://www.nhlbi.nih.gov/health-topics/chest-x-ray [accessed on Aug 25, 2021]
https://medlineplus.gov/ency/article/003804.htm [accessed on Aug 25, 2021]
https://www.radiologyinfo.org/en/info/chestrad [accessed on Aug 25, 2021]
https://www.emedicinehealth.com/chest_x-ray/article_em.htm [accessed on Aug 25, 2021]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
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Chest X-ray of transfusion-related acute lung injury (TRALI syndrome) compared to chest X-ray of the same subject afterwards.
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Tuberculosis X-ray
An anteroposterior X-ray of a patient diagnosed with advanced bilateral pulmonary tuberculosis. This AP X-ray of the chest reveals the presence of bilateral pulmonary infiltrate (white triangles), and caving forma.
Image by CDC / Der Lange
Respiratory Syncytial Virus
This highly-magnified, 1981 transmission electron microscopic (TEM) image, reveals some of the morphologic traits exhibited by a human respiratory syncytial virus (RSV). The virion is variable in shape, and size, with an average diameter between 120-300nm. RSV is the most common cause of bronchiolitis and pneumonia among infants and children, under 1-year of age.
Image by CDC/ E. L. Palmer
Q Fever Pneumonia X-ray
Combination of two x-rays (A) normal chest x-ray (B) x-ray documenting Q fever pneumonia.
Image by US Gov
Chest X Ray
A Lateral Chest X-Ray with the heart shadow outlined.
Image by US Army
Projectional radiography
Image relating focal spot size to geometric unsharpness in projectional radiography.
Image by Source images by Blausen Medical and LadyofHats (Mariana Ruiz Villarreal) Derivative by Mikael Haggstrom
Chest Radiograph
Chest X-Ray : Specialized test, like a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan, may be needed to confirm the presence of an aneurysm.
Image by TheVisualMD
X-ray of Healthy Lung
This image shows an x-ray of healthy lungs.
Image by TheVisualMD
Cancer screening
Cancer Imaging: X-Rays : Chest X-rays can be used to show the presence of tumors, as for lung cancer, but they may also indicate problems associated with cancer. An X-ray may produce images suggestive of fluid accumulation, masses, or enlarged lymph nodes.
Image by TheVisualMD
Lung Cancer
Chest X-ray (Cancer): This is an x-ray image of a chest. Both sides of the lungs are visible with a growth on the left side of the lung, which could possibly be lung cancer.
Image by National Cancer Institute
Chest X Ray
Mediastinal structures on a chest radiograph.
Image by Mikael Haggstrom, from source images by ZooFari, Stillwaterising and Gray's Anatomy creators
CT Chest Scan of Pleura effusion
CT scan of chest showing loculated pleural effusion in left side. Some thickening of pleura is also noted. From my personal collection. Permission obtained from patient.
Image by Drriad
Chest X-ray (Cancer)
This is an x-ray image of a chest. Both sides of the lungs are visible with a growth on the left side of the lung, which could possibly be lung cancer.
Image by National Cancer Institute / Unknown Photographer
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CT Scans (VIDEO)
This video shows how modern science of scanning can expose the health condition of the patient. The video starts with a patient undergoing CT scanning, an x-ray procedure that combines many x-ray images with the aid of a computer to generate cross-sectional views and, if needed, three-dimensional images of the internal organs and structures of the body. Visible are the heart, lungs, and arteries of a patient.
Video by TheVisualMD
Chest X-Ray
Air-filled trachea and lungs Diaphragmatic domes Mediastinal structures Vascular markings
Arrows indicate costophrenic angles
Image by US Army
Gallstones
Gallstones as seen on plain x-ray.
Image by James Heilman, MD
Hemoptysis x-ray
Hemoptysis can be discovered with the help of radiology.
Image by Aidan Jones from Oxford, U.K.
X-ray of Lung with Pulmonary Edema
Within the lungs, the main airways (bronchi) branch off into smaller passageways, the smallest of which are called bronchioles. At the end of the bronchioles are tiny air sacs (alveoli). Pulmonary edema is a condition caused when excess fluid collects in these air sacs, making it difficult to breathe. Fluid in the lungs can be caused by pneumonia, acute respiratory distress and other conditions, but in most cases, the cause of pulmonary edema is heart problems (when a damaged heart can't pump enough blood and fluid leaks into the lungs).
Image by TheVisualMD
What To Expect During and After Implantable Cardioverter Defibrillator Surgery
A normal chest X-ray after placement of an ICD, showing the ICD generator in the upper left chest and the ICD lead in the right ventricle of the heart. Note the 2 opaque coils along the ICD lead.
Image by Gregory Marcus, MD, MAS, FACC
This browser does not support the video element.
Chest X-ray: NCI B-roll [video]
NCI B-roll of a patient receiving a Chest X-ray. This video is silent.
Video by National Cancer Institute (NCI)
X-Ray of Aneurysm within Chest frontal view
Most aneurysms are detected in the course of an exam, such as a physical exam or a chest X-ray, being performed for a different reason.
Image by TheVisualMD
Pleural Effusion: Tests
Pleural effusion Chest x-ray of a pleural effusion. The arrow A shows fluid layering in the right pleural cavity. The B arrow shows the normal width of the lung in the cavity. A pleural effusion: as seen on chest X-ray. The A arrow indicates fluid layering in the right chest. The B arrow indicates the width of the right lung. The volume of the lung is reduced because of the collection of fluid around the lung.Pleural effusion Chest x-ray of a pleural effusion. The arrow A shows fluid layering in the right pleural cavity. The B arrow shows the normal width of the lung in the cavity. A pleural effusion: as seen on chest X-ray. The A arrow indicates fluid layering in the right chest. The B arrow indicates the width of the right lung. The volume of the lung is reduced because of the collection of fluid around the lung.
Image by CDC InvictaHOG
Coccidioidomycosis
This anteroposterior (AP) chest x-ray revealed pulmonary changes indicative of pulmonary fibrosis in a case of coccidioidomycosis, caused by fungal organisms of the genus, Coccidioides. Because these changes also resemble those seen in other lung infections including tuberculosis, the findings uncovered with a chest x-ray needs to be coupled with serologic testing, as well as possible tissue biopsy. The degree of fibrotic changes, indicative of scarring found on x-ray, can be directly correlated to the severity of the fungal infection.
Image by CDC/ Dr. Lucille K. Georg
How Is Acute respiratory distress syndrome (ARDS) Diagnosed?
Chest X-Ray: Acute respiratory distress syndrome on plain Xray
Image by James Heilman, MD
How Are Asbestos-Related Lung Diseases Diagnosed?
Early Asbestosis in a Retired Pipe Fitter : Chest X-ray in asbestosis shows plaques above diaphragm
Image by Clinical Cases
Aspergillosis
This was a photomicrograph of a lung tissue specimen, harvested from a caged, sulfur-crested cockatoo, that depicted some of the histopathologic changes that had been caused by the fungal organism, Aspergillus fumigatus, in a case of avian pulmonary aspergillosis. Here, you are able see how the periodic acid-Schiff (PAS) stain, revealed A. fumigatus ultrastructural morphology including conidial heads and mycelium.
Image by CDC/ Dr. William Kaplan
Pleural Effusion - Defined
A large left sided pleural effusion as seen on an upright chest X-ray
Image by Drriad
Pleural Effusion: Tests
A large left sided pleural effusion as seen on an upright chest X-ray
Image by James Heilman MD
Breast implants
Chest X-ray showing breast implants
Image by James Heilman
Living With Idiopathic Pulmonary Fibrosis
No cure is available for idiopathic pulmonary fibrosis (IPF) yet. Your symptoms may get worse over time. As your symptoms worsen, you may not be able to do many of the things that you did before you had IPF.
However, lifestyle changes and ongoing care can help you manage the disease.
If you're still smoking, the most important thing you can do is quit. Talk with your doctor about programs and products that can help you quit. Also, try to avoid secondhand smoke. Ask family members and friends not to smoke in front of you or in your home, car, or workplace.
Image by Drriad
Symptoms and Spread of SARS (Severe acute respiratory syndrome)
A chest x-ray showing increased opacity in both lungs, indicative of pneumonia, in a patient with SARS.
Image by CDC
Chilaiditi syndrome
Chest X-ray showing obvious Chilaiditi's sign, or presence of gas in the right colic angle between the liver and right hemidiaphragm (left side of the image).
Piper's Sign: In days gone by the lateral chest x-ray (demonstrating greater opacity in the aortic arch and descending aorta than the thoracic spine) gave an indication to the degree of calcified plaque burden a patient had. This has been known as Piper's sign and can often be seen in elderly persons particularly those with concomitant osteoporosis.
Image by U4077905
Aspect of a bulky thymoma (red circle) on the chest x-ray.
Aspect of a bulky thymoma (red circle) on the chest x-ray.
Image by Stockholm
Lambert–Eaton myasthenic syndrome-Chest X-ray showing a tumor in the left lung (right side of the image)
Lambert–Eaton myasthenic syndrome-Chest X-ray showing a tumor in the left lung (right side of the image)
Image by Lange123 at German Wikipedia
Chest X-ray in influenza and Haemophilus influenza
Chest X-ray of a 76 year old woman, who developed cough and labored breathing. First testing showed influenza B virus, and later a nasopharyngeal swab detected Haemophilus influenzae. The H influenzae presumably developed as an opportunistic infection secondary to the flu. This X-ray was taken 2 weeks after cultures and start of antibiotics, showing delayed pneumonic infiltrates that were only vaguely visible on initial (not shown) X-rays.
Image by Mikael Häggström
Chest X-ray in influenza and Haemophilus influenzae, lateral
Chest X-ray of a 76 year old woman, who developed cough and labored breathing. First testing showed influenza B virus, and later a nasopharyngeal swab detected Haemophilus influenzae. The H influenzae presumably developed as an opportunistic infection secondary to the flu. This X-ray was taken 2 weeks after cultures and start of antibiotics, showing delayed pneumonic infiltrates that were only vaguely visible on initial (not shown) X-rays.
Image by Mikael Häggström
Fungal Parasites and Pathogens
(a) Ringworm presents as a red ring on skin; (b) Trichophyton violaceum, shown in this bright field light micrograph, causes superficial mycoses on the scalp; (c) Histoplasma capsulatum is an ascomycete that infects airways and causes symptoms similar to influenza. (credit a: modification of work by Dr. Lucille K. Georg, CDC; credit b: modification of work by Dr. Lucille K. Georg, CDC; credit c: modification of work by M. Renz, CDC; scale-bar data from Matt Russell)
Image by CNX Openstax
This anteroposterior (AP) chest x-ray revealed radiologic evidence of pulmonary pneumocystosis in the form of bilateral pulmonary interstitial infiltrates. This infection was due to the presence of an opportunistic fungal infection by the fungal organism Pneumocystis jirovecii, formerly known as Pneumocystis carinii. (This image was provided by Jonathan W.M. Gold. M.D., Assoc. Dir. Special Microbiology Lab, Assist. Attending Physician, Memorial Sloan-Kettering Cancer Center and Assist. Prof. of Medicine, Cornell Univ. Med. College, New York.)
Pneumocystis jirovecii is the causative agent of Pneumocystis pneumonia (PCP), one of the most frequent and severe opportunistic infections in immunocompromised patients. Pneumocystis organisms represent a large group of species of atypical fungi with universal distribution and pulmonary tropism, and each species has a strong specificity for a given mammalian host species.
Image by CDC/ Jonathan W.M. Gold, MD
Chest X-ray PA inverted and enhanced
Chest X-ray PA inverted and enhanced
Image by Stillwaterising
Chest X-Ray of Canadian dollar coin in esophagus of child
PA view Chest X-Ray of Canadian dollar coin in esophagus of child. Released per permission of mother.
Image by Samir (talk)
Chest X Ray
Structures shown: Air-filled trachea and lungs Diaphragmatic domes Mediastinal structures Vascular markings. Arrows indicate costophrenic angles
Image by US Army
Thoracic diaphragm
X-ray of chest, showing top of diaphragm.
Image by OpenStax College
Chest X Ray
Roentgenogram or Medical X-ray image. May not be to scale.
Aspect of a bulky thymoma (red circle) on the chest x-ray.
Stockholm
Lambert–Eaton myasthenic syndrome-Chest X-ray showing a tumor in the left lung (right side of the image)
Lange123 at German Wikipedia
Chest X-ray in influenza and Haemophilus influenza
Mikael Häggström
Chest X-ray in influenza and Haemophilus influenzae, lateral
Mikael Häggström
Fungal Parasites and Pathogens
CNX Openstax
This anteroposterior (AP) chest x-ray revealed radiologic evidence of pulmonary pneumocystosis in the form of bilateral pulmonary interstitial infiltrates. This infection was due to the presence of an opportunistic fungal infection by the fungal organism Pneumocystis jirovecii, formerly known as Pneumocystis carinii. (This image was provided by Jonathan W.M. Gold. M.D., Assoc. Dir. Special Microbiology Lab, Assist. Attending Physician, Memorial Sloan-Kettering Cancer Center and Assist. Prof. of Medicine, Cornell Univ. Med. College, New York.)
CDC/ Jonathan W.M. Gold, MD
Chest X-ray PA inverted and enhanced
Stillwaterising
Chest X-Ray of Canadian dollar coin in esophagus of child
Patrick J. Lynch, medical illustrator; C. Carl Jaffe, MD, cardiologist.
7:02
Reading a chest X-ray
Osmosis/YouTube
Chest X-ray of transfusion-related acute lung injury (TRALI syndrome) compared to chest X-ray of the same subject afterwards.
Altaf Gauhar Haji, Shekhar Sharma, DK Vijaykumar and Jerry Paul
EKG
Electrocardiogram
Also called: EKG, ECG
An electrocardiogram (EKG) is a test that measures electrical signals in your heart. An abnormal EKG can be a sign of heart damage or disease.
Electrocardiogram
Also called: EKG, ECG
An electrocardiogram (EKG) is a test that measures electrical signals in your heart. An abnormal EKG can be a sign of heart damage or disease.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
EKG results are normal with a consistent heartbeat and rhythm.
Related conditions
An electrocardiogram (EKG) test is a simple, painless, and quick test that records your heart's electrical activity. Each time your heart beats, an electrical signal travels through your heart. The signal triggers your heart's four chambers to contract (squeeze) in the proper rhythm so that your heart can pump blood to your body.
An EKG recording of these signals looks like wavy lines. Your provider can read these lines to look for abnormal heart activity that may be a sign of heart disease or damage.
An EKG can show:
How fast your heart is beating
Whether the rhythm of your heartbeat is steady or irregular
The strength and timing of the electrical signals passing through each part of your heart
Sometimes information from an EKG can help measure the size and position of your heart's chambers.
An EKG is often the first test you'll have if you have signs of a heart condition. It may be done in your provider's office, an outpatient clinic, in a hospital before surgery, or as part of another heart test called a stress test.
An EKG test is also called an ECG. EKG is based on the German spelling, elektrokardiogramm. EKG may be preferred over ECG to avoid confusion with an EEG, a test that measures brain waves.
An EKG test is used to help diagnose and monitor many types of heart conditions and their treatment. These conditions include:
Arrhythmia
Cardiomyopathy
Coronary artery disease
Heart attack
Heart failure
Heart valve diseases
Congenital heart defects
EKG tests are mainly used for people who have symptoms of a heart condition or have already been diagnosed with a heart condition. They are not generally used to screen people who don't have symptoms unless they have an increased risk of developing heart disease. Your provider can explain your risk for heart disease and let you know if need to have an EKG test. In certain cases, your provider may have you see a cardiologist, a doctor who specializes in heart diseases.
You may need an EKG test if you have symptoms of a heart condition, including:
Chest pain
Rapid or irregular heartbeat
Shortness of breath
Dizziness
Fatigue
A decrease in your ability to exercise
You may also need an EKG to:
Find out if you had a heart attack in the past but didn't know it
Monitor your heart if you have a known heart condition
Check how well your heart treatment is working, including medicine and/or a pacemaker
Check your heart health:
Before having surgery
If you have an increased risk for developing heart disease because:
Heart disease runs in your family
You have another condition, such as diabetes, that makes your risk higher than normal
An EKG test only takes a few minutes. It generally includes these steps:
You will lie on an exam table.
A provider will place several electrodes (small sensors that stick to your skin) on your arms, legs, and chest. The provider may need to shave body hair to make sure the electrodes stay on.
The electrodes are attached by wires to a computer or a special EKG machine
You will lie very still while your heart's electrical activity is recorded on a computer or printed on paper by an EKG machine.
You don't need any special preparations for an EKG test.
There is very little risk to having an EKG. You may feel a little discomfort or skin irritation after the electrodes are removed. The EKG doesn't send any electricity to your body. It only records electrical signals from your heart, so there's no risk of electric shock.
Your provider will check your EKG results for a steady heartbeat and rhythm. If your results are not normal, it may be a sign of a heart condition. The specific condition depends on which part of your EKG wasn't normal.
You may need to have other heart health tests before your provider can make a diagnosis. Your provider can explain what your test results mean for your heart health and treatment.
An EKG is a "snapshot" of your heart's activity over a very short time. If you have heart symptoms that come and go, a regular EKG may not catch the problem. In that case, your provider may recommend that you wear a small portable EKG monitor that can record your heart for days or longer while you do your normal activities. You may also need a longer EKG recording if your provider wants to check how well your heart is working after a heart attack or to see if treatment is helping you.
There are many types of long-term EKG monitors. The two main groups are Holter monitors, which can be worn for up to two days, and event monitors, which may record your heart activity for weeks to years depending on the type.
A Holter monitor is about the size of a small camera. You usually wear it on a belt or strap around your neck for a day or two. Wires under your clothes attach to electrodes that stick to your chest. The monitor records your heart's electrical signals the whole time you're wearing it. You may be asked to keep a diary of your symptoms during the test period. After the test period, you remove the monitor and return it according to the instructions. A provider will review the recording of your heart's electrical activity from the monitor.
An event monitor records your heart's electrical activity when you press a button or when the device detects abnormal heart activity. There two main types of event monitors:
Event monitors that you wear or carry with you. You wear some monitors on your chest or wrist. Other monitors are designed to carry. If you have symptoms, you hold the monitor to your chest. These event monitors may be used for weeks to months. Some of them wirelessly transmit information about your heart to a provider. Others must be returned so a provider can examine the recorded information.
Event monitors that are inserted under the skin of your chest. These are called implantable event monitors. They are put under your skin during minor surgery that's often done in a doctor's office. These monitors can track your heart's electrical activity for years. You may need this type of EKG monitor if you had a stroke or frequent fainting, and your provider hasn't found the cause. Implantable monitors wirelessly transmit the information they record so your provider can regularly check it.
Electrocardiogram: MedlinePlus Medical Test [accessed on Mar 09, 2023]
Electrocardiogram: MedlinePlus Medical Encyclopedia [accessed on Feb 04, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (35)
How to Read an Electrocardiogram (ECG): Introduction – Cardiology | Lecturio
Video by Lecturio Medical/YouTube
Major Types of Heart Block
Video by Jeff Otjen/YouTube
How An ECG Works
Video by LivingHealthyChicago/YouTube
This browser does not support the video element.
What are Arrhythmias?
Your heart is electric. In this video you'll see how your heart's electrical system works, and what happens when it malfunctions. Voyage inside the human body as Dr. Mehmet Oz and others explain the dangers of heart arrhythmias, including tachycardia, bradycardia, and atrial fibrillation.
Video by TheVisualMD
12 Lead ECG Explained, Animation
Video by Alila Medical Media/YouTube
Bundle Branch Block, Animation.
Video by Alila Medical Media/YouTube
QRS Transitional Zone. See link for real voice update in description!
Video by Alila Medical Media/YouTube
ECG Interpretation Basics - ST Segment Changes. See link for real voice update in description!
Video by Alila Medical Media/YouTube
Cardiac Axis Interpretation. See link for real voice update in description!
Video by Alila Medical Media/YouTube
Electrical system of the heart | Circulatory system physiology | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Cardiovascular | EKG Basics
Video by Ninja Nerd/YouTube
Cardiovascular | EKG's
Video by Ninja Nerd/YouTube
Normal sinus rhythm on an EKG | Circulatory System and Disease | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Cardiac Conduction System and Understanding ECG, Animation.
Video by Alila Medical Media/YouTube
Willem Einthoven and the ECG - Stuff of Genius
Video by Stuff of Genius - HowStuffWorks/YouTube
Electrocardiogram (ECG)
A useful tool for determining whether a person has heart disease, an electrocardiogram (ECG) is a test that records the electrical activity of the heart. An ECG, which is painless (no electricity is sent through the body), is used to measure damage to the heart, how fast the heart is beating and whether it is beating normally, the effects of drugs or devices used to control the heart (such as a pacemaker), and the size and position of the heart chambers.
Image by TheVisualMD
Cardiac cycle
Cardiac Cycle vs Electrocardiogram
Image by OpenStax College
Medical Checkups
Image by TheVisualMD
Electrocardiogram
Electrocardiograms (EKGs) are the most commonly given test used to diagnose coronary artery disease. They record the heart's electrical activity and show evidence of angina or heart attack.
Image by TheVisualMD
electrocardiogram-illustration made up from Medications
A normal tracing shows the P wave, QRS complex, and T wave. Also indicated are the PR, QT, QRS, and ST intervals, plus the P-R and S-T segments.
Image by CNX Openstax
What To Expect After an Electrocardiogram
Normal ECG/EKG complex with labels
Image by Derivative: Hazmat2 Original: Hank van Helvete
Cardiac Stress Test
The image shows a patient having a stress test. Electrodes are attached to the patient's chest and connected to an EKG (electrocardiogram) machine. The EKG records the heart's electrical activity. A blood pressure cuff is used to record the patient's blood pressure while he walks on a treadmill.
Image by National Heart Lung and Blood Institute
Relationship between the Cardiac Cycle and ECG
Initially, both the atria and ventricles are relaxed (diastole). The P wave represents depolarization of the atria and is followed by atrial contraction (systole). Atrial systole extends until the QRS complex, at which point, the atria relax. The QRS complex represents depolarization of the ventricles and is followed by ventricular contraction. The T wave represents the repolarization of the ventricles and marks the beginning of ventricular relaxation.
Image by CNX Openstax
The Electric Heart
Image by TheVisualMD
Electrocardiogram (EKG)
Electrocardiogram (EKG) is a test used to measure the electrical activity of the heart.
Image by U.S. National Library of Medicine
Comparison of Arrhythmia and Normal ECG
As the muscle tissue in an overstressed heart expands, it tears and scars. The resulting tissue - hardened and marred - does not conduct electricity well. The result is that the system can no longer be relied on to deliver the carefully synchronized pattern of jolts needed to keep the heart pumping smoothly. Doctors call it \"arrhythmia.\" The heart is literally \"skipping a beat.\" This can be measured by an electrocardiogram (ECG). In some cases, arrhythmia can mean simply that the heartbeat is too fast or too slow - a bothersome but not necessarily life-threatening condition. In the worst cases, the arrhythmia indicates a potentially lethal instability in the heart's electric system. The signals that control the heart's contractions get crossed and the heart spasms. If not corrected immediately, this fibrillation of the heart is often fatal. In the U.S., more than 1,000 people die every day from sudden cardiac death, or cardiac arrest.
Image by TheVisualMD
Heart Revealing Chamber and Valve
Your heart beats faster or slower depending on information from your brain, which monitors your body's need for blood. However, the basic rhythm of your heart is automatic; it does not depend on signals from your brain. Your heart cells can generate their own electrical signals, which trigger the contractions and cause the entire heart to pump in synchrony. A specialized bundle of muscle and nerve cells called the sinoatrial node (SA node) sits at the top of the right atrium and is the pacemaker of the heart. It generates the signal for the atria to contract and send blood to the ventricles. A similar node - the atrioventricular or AV node - sits at the atrioventricular septum near the bottom of the right atrium and relays the signal from the SA node to the ventricles to contract and pump blood out of the heart. An electrocardiogram (ECG) measures the electrical signals given off by these two nodes and their conduction through the heart. By looking at the frequency and the height of the peaks and valleys of these signals on an ECG, healthcare professionals get a very good idea of how well the electrical system of your heart is working.
Image by TheVisualMD
Electrocardigram
An electrocardiogram (EKG) detects and records the heart's electrical activity. When the electrical impulse passes through the atria a small peak is recorded (P), followed by a steep spike as it erupts through the ventricles (R), and then another small peak (T) as the wave passes through and the heart repolarizes (recharges) itself for the next beat.
Image by TheVisualMD
Electro- cardiogram
Electrocardiograms, or EKGs, record the electrical activity of the heart. Since injured heart muscle conducts electrical impulses abnormally, the EKG shows if the patient has had or is having a heart attack. It is usually the first test performed.
Image by TheVisualMD
SinusRhythmLabels
Schematic diagram of normal sinus rhythm for a human heart as seen on ECG. In atrial fibrillation, however, the P waves, which represent depolarization of the atria, are absent.
Image by Agateller (Anthony Atkielski)
How To Use an Automated External Defibrillator
The image shows a typical setup using an automated external defibrillator (AED). The AED has step-by-step instructions and voice prompts that enable an untrained bystander to correctly use the machine.
Image by National Heart Lung and Blood Institute
Who Needs an Implantable Cardioverter Defibrillator?
Lead II (2) ECG EKG strip of an AICD ICD converting a patient back into thier baseline cardiac ryhthm. The AICD fires near the end of the strip, where the straight line is seen.
Image by Public Domain
Cardiac Cycle
CG Animated Human Heart cut section showing the atria, ventricles and valves, synced with wiggers diagram.
Image by DrJanaOfficial/Wikimedia
Mammalian Heart and Blood Vessels
The beating of the heart is regulated by an electrical impulse that causes the characteristic reading of an ECG. The signal is initiated at the sinoatrial valve. The signal then (a) spreads to the atria, causing them to contract. The signal is (b) delayed at the atrioventricular node before it is passed on to the (c) heart apex. The delay allows the atria to relax before the (d) ventricles contract. The final part of the ECG cycle prepares the heart for the next beat.
Image by CNX Openstax
9:53
How to Read an Electrocardiogram (ECG): Introduction – Cardiology | Lecturio
Lecturio Medical/YouTube
9:23
Major Types of Heart Block
Jeff Otjen/YouTube
2:45
How An ECG Works
LivingHealthyChicago/YouTube
3:27
What are Arrhythmias?
TheVisualMD
3:27
12 Lead ECG Explained, Animation
Alila Medical Media/YouTube
3:48
Bundle Branch Block, Animation.
Alila Medical Media/YouTube
3:50
QRS Transitional Zone. See link for real voice update in description!
Alila Medical Media/YouTube
1:24
ECG Interpretation Basics - ST Segment Changes. See link for real voice update in description!
Alila Medical Media/YouTube
3:32
Cardiac Axis Interpretation. See link for real voice update in description!
Alila Medical Media/YouTube
9:43
Electrical system of the heart | Circulatory system physiology | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
52:29
Cardiovascular | EKG Basics
Ninja Nerd/YouTube
20:37
Cardiovascular | EKG's
Ninja Nerd/YouTube
8:53
Normal sinus rhythm on an EKG | Circulatory System and Disease | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
3:45
Cardiac Conduction System and Understanding ECG, Animation.
Alila Medical Media/YouTube
1:46
Willem Einthoven and the ECG - Stuff of Genius
Stuff of Genius - HowStuffWorks/YouTube
Electrocardiogram (ECG)
TheVisualMD
Cardiac cycle
OpenStax College
Medical Checkups
TheVisualMD
Electrocardiogram
TheVisualMD
electrocardiogram-illustration made up from Medications
GDJ
Electrocardiogram
CNX Openstax
What To Expect After an Electrocardiogram
Derivative: Hazmat2 Original: Hank van Helvete
Cardiac Stress Test
National Heart Lung and Blood Institute
Relationship between the Cardiac Cycle and ECG
CNX Openstax
The Electric Heart
TheVisualMD
Electrocardiogram (EKG)
U.S. National Library of Medicine
Comparison of Arrhythmia and Normal ECG
TheVisualMD
Heart Revealing Chamber and Valve
TheVisualMD
Electrocardigram
TheVisualMD
Electro- cardiogram
TheVisualMD
SinusRhythmLabels
Agateller (Anthony Atkielski)
How To Use an Automated External Defibrillator
National Heart Lung and Blood Institute
Who Needs an Implantable Cardioverter Defibrillator?
Public Domain
Cardiac Cycle
DrJanaOfficial/Wikimedia
Mammalian Heart and Blood Vessels
CNX Openstax
Echocardiography
Echocardiography
Also called: Echo, Echocardiogram, Cardiac Ultrasound, Ultrasound of the Heart
An echocardiography, or echo, is a painless test that uses sound waves to create moving pictures of your heart. The pictures show the size and shape of your heart. They also show how well your heart's chambers and valves are working. Doctors use an echo to diagnose many different heart problems, and to check how severe they are.
Echocardiography
Also called: Echo, Echocardiogram, Cardiac Ultrasound, Ultrasound of the Heart
An echocardiography, or echo, is a painless test that uses sound waves to create moving pictures of your heart. The pictures show the size and shape of your heart. They also show how well your heart's chambers and valves are working. Doctors use an echo to diagnose many different heart problems, and to check how severe they are.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
Echocardiography (echo) shows the size, structure, and movement of various parts of your heart. These parts include the heart valves, the septum (the wall separating the right and left heart chambers), and the walls of the heart chambers.
Related conditions
Echocardiography, or echo, is a painless test that uses sound waves to create moving pictures of your heart. The pictures show the size and shape of your heart and how well your heart is pumping blood. A type of echo called Doppler ultrasound shows how well blood flows through your heart's chambers and valves.
There are several types of echocardiography:
Transthoracic echocardiography is the most common type of echo. It involves placing a device called a transducer on your chest after a gel is applied to your skin. The device sends special sound waves, called ultrasound, through your chest wall to your heart. As the ultrasound waves bounce off the structures of your heart, a computer in the echo machine converts them into pictures on a screen.
Stress echocardiography is done as part of a stress test. During a stress test, you exercise or take medicine to make your heart work hard and beat fast. A technician will use echo to create pictures of your heart before you exercise and as soon as you finish.
Transesophageal echocardiography gives your doctor a more detailed view of your heart. During this test, the transducer is attached to the end of a flexible tube. The tube is guided down your throat and into your esophagus (the passage leading from your mouth to your stomach). Your doctor will inject medicine into a vein to help you relax during the test.
Fetal echocardiography is used to look at an unborn baby's heart to check for heart problems. When recommended, the test is commonly done at about 18 to 22 weeks of pregnancy. For this test, the transducer is moved over the pregnant person's belly.
Three-dimensional (3D) echocardiography creates 3D images of your heart. This may be done as part of a transthoracic or transesophageal echo.
Echoes from the sound waves form a picture of the size, shape, and position of the heart on a computer screen (echocardiogram). The pictures can also show the parts of the inside of the heart, such as the valves, and the motion of the heart while it is beating.
Echo can detect blood clots inside your heart, fluid buildup in the pericardium (the sac around the heart), tumors, and problems with the aorta. The aorta is the main artery that carries oxygen-rich blood from your heart to your body. Echo also can help your doctor find the cause of abnormal heart sounds, such as heart murmurs, due to damaged heart valves. Your doctor also might use echo to see how well your heart responds to certain treatments.
You may have the echocardiography in your doctor’s office or at a hospital. Echocardiography usually takes less than an hour to do. For some types of echo, your doctor will need to inject saline or a special dye into one of your veins. This makes your heart show up more clearly on the echo pictures.
For most types of echo, a technician applies gel to your chest. The gel helps sound waves reach your heart. The technician moves a transducer (wand-like device) around on your chest. The transducer connects to a computer. It transmits ultrasound waves into your chest, and the waves bounce (echo) back. The computer converts the echoes into pictures of your heart.
For a transesophageal echo, you’ll be given oxygen through a tube in your nose. The back of your mouth will be numbed with gel or spray. Your doctor will gently place the tube with the transducer in your throat and guide it down until it is in place behind your heart. The pictures of your heart are then recorded as your doctor moves the transducer around in your esophagus and stomach. You shouldn’t feel any discomfort as this happens. Your throat might be sore for a few hours after the test.
You won’t need to do anything to prepare for most types of echo. For a transesophageal echo, your doctor may ask you not to eat or drink for 8 hours before the test.
If you have a transesophageal echo, you may experience some side effects from the medicine given to help you relax, such as problems breathing or nausea (feeling sick to your stomach). Rarely, the tube used causes minor throat injuries.
A normal echocardiogram reveals normal heart valves and chambers and normal heart wall movement.
An abnormal echocardiogram can mean many things. Some abnormalities are very minor and do not pose major risks. Other abnormalities are signs of serious heart disease. You will need more tests by a specialist in this case. It is very important to talk about the results of your echocardiogram with your provider.
Heart Tests | NHLBI, NIH. Mar 24, 2022 [accessed on Dec 13, 2023]
Heart Health Tests: MedlinePlus. National Library of Medicine. Feb 28, 2017 [accessed on Dec 13, 2023]
Echocardiogram: MedlinePlus Medical Encyclopedia [accessed on Dec 13, 2023]
Additional Materials (7)
Heart normal transthoracic echocardiography
Heart normal transthoracic echocardiography views
Image by Patrick J. Lynch, medical illustrator; C. Carl Jaffe, MD, cardiologist
Echocardiography of hypertrophic-obstructive cardiomyopathy in a domestic cat
Hypertrophic-obstructive cardiomyopathy in a domestic shorthair cat, visualized by echocardiography, color-doppler, right parasternal, long axis. Note the thickened septum, the obstructed LVOT and the mitral regurgitation
Image by Kalumet
Medical ultrasound
This is a sonographer performing an ultrasound examination of the heart of a baby. The child's mother is present. This examination is called echocardiography.
Image by Gislaug Thorsteinsson
Echocardiography – What you need to know
Video by Cleveland Clinic/YouTube
V. Pavliuk, MD, PhD. Echocardiography for beginners
Video by msvitu1/YouTube
What is Echocardiography?
Video by Mayo Clinic/YouTube
Fetal Echocardiography: Protocol and Technique
Video by Intersocietal Accreditation Commission/YouTube
Heart normal transthoracic echocardiography
Patrick J. Lynch, medical illustrator; C. Carl Jaffe, MD, cardiologist
Echocardiography of hypertrophic-obstructive cardiomyopathy in a domestic cat
Kalumet
Medical ultrasound
Gislaug Thorsteinsson
6:29
Echocardiography – What you need to know
Cleveland Clinic/YouTube
46:28
V. Pavliuk, MD, PhD. Echocardiography for beginners
msvitu1/YouTube
4:14
What is Echocardiography?
Mayo Clinic/YouTube
1:02:05
Fetal Echocardiography: Protocol and Technique
Intersocietal Accreditation Commission/YouTube
Treatment
Phonocardiograms from normal and abnormal heart sounds with pressure diagrams with location on the precordium
Image by Madhero88
Phonocardiograms from normal and abnormal heart sounds with pressure diagrams with location on the precordium
Phonocardiograms from normal and abnormal heart sounds with pressure diagrams with location on the precordium
Image by Madhero88
How Is a Heart Murmur Treated?
A heart murmur isn't a disease. It's an extra or unusual sound heard during the heartbeat. Thus, murmurs themselves don't require treatment. However, if an underlying condition is causing a heart murmur, your doctor may recommend treatment for that condition.
Innocent (Harmless) Heart Murmurs
Healthy children who have innocent (harmless) heart murmurs don't need treatment. Their heart murmurs aren't caused by heart problems or other conditions.
Pregnant women who have innocent heart murmurs due to extra blood volume also don't need treatment. Their heart murmurs should go away after pregnancy.
Abnormal Heart Murmurs
If you or your child has an abnormal heart murmur, your doctor will recommend treatment for the disease or condition causing the murmur.
Some medical conditions, such as anemia or hyperthyroidism, can cause heart murmurs that aren't related to heart disease. Treating these conditions should make the heart murmur go away.
If a congenital heart defect is causing a heart murmur, treatment will depend on the type and severity of the defect. Treatment may include medicines or surgery.
If acquired heart valve disease is causing a heart murmur, treatment usually will depend on the type, amount, and severity of the disease.
Currently, no medicines can cure heart valve disease. However, lifestyle changes and medicines can treat symptoms and help delay complications. Eventually, though, you may need surgery to repair or replace a faulty heart valve.
Source: National Heart, Lung, and Blood Institute (NHLBI)
Additional Materials (3)
Phonocardiograms from normal and abnormal heart sounds with pressure diagrams with location on the precordium
Phonocardiograms from normal and abnormal heart sounds with pressure diagrams with location on the precordium
Image by Madhero88
Four Basic Treatment Options for Heart Valve Patients
Video by American Heart Association/YouTube
Heart Sounds and Heart Murmurs, Animation.
Video by Alila Medical Media/YouTube
Phonocardiograms from normal and abnormal heart sounds with pressure diagrams with location on the precordium
Madhero88
3:57
Four Basic Treatment Options for Heart Valve Patients
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Heart Murmur
A heart murmur is an unusual sound heard between heartbeats. Murmurs sometimes sound like a whooshing or swishing noise. Murmurs may be harmless, also called innocent, or abnormal. Abnormal murmurs may mean a valve isn't working normally. Learn about causes, symptoms, and treatment.