Urgent condition in cardiovascular diseases

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The tone in hypertension: Auscultatory findings in arterial hypertensionArterial hypertension, popularly known as high blood pressure is known, is one of the most common cardiovascular disease worldwide and represents a significant risk for heart attacks, strokes and kidney disease. During the clinical examination, auscultation plays — listening to body sounds with a stethoscope, an important role for the assessment of cardiac and vascular functions in patients with hypertension.1. Heart murmurs and heart sound changesIn patients with long-standing hypertension may develop left ventricular hypertrophy, because the heart has to work against an increased peripheral resistance. This structural change can lead found to be characteristic Auscultation:Amplification of the Aortenklappentons (A2): Due to the increased pressure in the aortic arch of the second heart sound (S 2) in the area of the aortic valve louder to be perceived, especially in the base of the heart.Displacement of the apical impulse: In the case of left ventricular hypertrophy may be the apical heart strike laterally and downwardly moved, which in the case of simultaneous auscultation to a slight displacement of the heart Toni intensity.The occurrence of a fourth heart sound (S4): S4Sound, as a pre-systolic Gallop, can occur in the case of a stiff left ventricle (e.g., due to fibrosis or hypertrophy). It is produced by Vibration of the ventricular wall during the late atrial contraction, which suggests a reduced ventricular compliance.2. Vascular Sounds (Murmurs)Another important aspect of auscultation listening to the great vessels is:Aortic stenosis: In patients with arterial hypertension and concomitant aortic stenosis may be present, which leads to a systolic Flow murmur (systolic Murmur). This noise inside flows are typically of the aortic base in the neck (radiiert).Renal vascular stenosis: A secondary hypertension can be caused by a renal artery stenosis. Here is a systolic or systolic‑diastolic vessel can be monitored noise in the flank area or lateral to the navel.3. Blood pressure measurement and Korotkov soundsThe diagnostic cornerstone of high blood pressure is the blood pressure measurement according to the Korotkov‑. The so‑called Korotkov be listened to sounds:Phase I: First clear, continuous tones, — corresponds to the systolic blood pressure.Phase V: the Disappearance of the sounds — defines the diastolic blood pressure.In some patients, particularly in the elderly or in the case of very high systolic blood pressure can lead to the onset of the tones (Ausbruchton) if the gauge pressure drops below the diastolic value. This can lead to misinterpretations and requires careful measurement.4. Differential Diagnostic AspectsNot all abgehörbaren sounds are directly linked to high blood pressure. There are other causes, such as it is important:Heart valve defects,Anemia,Hyperthyroidismin order to be able to a targeted therapy can be initiated.ConclusionAuscultation is a simple, cost‑effective and non-invasive method, which can provide in the diagnosis and evaluation of patients with hypertension valuable information. Characteristic sounds and noises — such as a reinforced A2, a S4Tone or Vascular murmur's — can affect the accompanying structural or functional cardiac clues and the treatment of diseases. A careful clinical examination in combination with modern imaging allows a comprehensive assessment of the patient and contributes to the improvement of the long-term prognosis.