A squeaking heart

Jenny P · Mar 14, 2002

Mario, another cause of a squeaking sound in your chest may be that your chest hair is the cause of the squeak-- when you are first listening, you may be not getting the best seal of the diaphragm against the chest wall and with the slight movement of the chest a couple of chest hairs may be rubbing the diaphragm in time with your heartbeat. Try listening with the bell of the stethescope and see if the squeak is still there. If it is, the sound MAY be cardiac in nature; if it isn't, the sound may be too high pitched or it may be an extraneous sound. And what kind of stethescope do you have: does it have one rubber tube (like the Littman styles) or 2 tubes(a sprague-rappaport style)? If you have the Sprague-Rappaport style, sometimes the tubes can be rubbing together and cause a squeaking sound in time with the heartbeat.

As a night nurse in CV-ICU or other types of critical care for 29 years, I have rarely if ever heard of a transient pericardial friction rub in an asymptomatic or non-surgical (heart surgery, that is) patient. If your heart would squeak with first waking, I think that I would have heard this somewhere along the way since I often try listen to patients' hearts without waking them all the way up. And remember, the heart ALWAYS pumps oxygenated blood to all parts of the body; you don't have to be awake for that to happen (or we would all die as soon as we fell asleep for the first time).

sharann, BSN, RN · Mar 14, 2002

Mario,

You are so cute!

You are gonna make quite a nurse!

mario_ragucci · Mar 14, 2002

It's not chest hairs, jeez. In my bedroom, in the morning, with no distractions, I am very atune to the sounds.

Although the responses here have been very insightful, I will now tell you my "gut" interpretation of this.

Heart muscles are in spiral bundles. The sound is like a "rubber band on a seesaw" if you have the imagination. The heart is a "functional syncytium." The cardiac muscles are regulated by the autonomic nervous system. When you sleep (and have nice dreams) I am imagining the heart gets the red light to slow down. I imagine that, an awake heart runs on 100% of the cells contracting, but when you sleep, a percentage of them are not needed, for several hours, so they go inactive, yet are connected. The SA node may not have the same "voltage" when you are asleep. All this contrbutes to sleep. And I think my brain/body knows when its gotta get a good sleep, and lets my heart relax.

The sound, I believe, in my heart, the hiccup/squeak, is the intercalated disks which are relaxed during sleep, and the plasma membranes re-energizing to full potential power. The chordae tendons tighten but the heart is relaxed from a sleep where some of the cells have fallen asleep too (with the go ahead to do so from the sympathetic and parasympathetic neurons, brought on by sleep), and it takes a stretch to stretch them. Until those tendons stretch, they make a sound.

It sounds like a rubberband that is taunt, getting stretched till the sound goes away.

Now my calling in life is to have a one-night-stand with a cardiac doctor and after she tells me about the sound she hears first thing in the morning, thats it, were through :-) Or i can spend the night in a hospital and have a cardiac doctor at bedside when I wake up. I'll let this go, thank you all again!!! And if anyone has anything else to add, i'd love to read.

sincerely

mario

wildhoney · Mar 14, 2002

Originally posted by sharann
Mario,
You are so cute!
You are gonna make quite a nurse!

LOL! I agree with you. I was thinking the exact same thing when I came across your post. :)

Edited to say: his patient's will definitely like him.

wildhoney · Mar 14, 2002

"My Squeakin' heart" could be a country song.

Oh.. this squeaking heart..... la la la.

lever5 · Mar 14, 2002

Mario,

Good education on hearts. You need lots of time to absorb, but it is wonderful. http://www.pacep.org/ since the heart works on the theory of automaticity; all cells must work like dominos. They just don't work as hard when you sleep. free site

Jenny P · Mar 14, 2002

Mario, the heart doesn't run at 100% capacity unless the body is extremely stressed. The heart's normal "Ejection Fraction" is usually around 60%. That means that in a normal waking state, the heart only pumps at 60% of its' capacity because we need a cardiac reserve in order to handle walking upstairs, or running, or even having sex. Anything that increases the heart rate or how hard the heart muscle contracts will increase the work of the heart. The heart doesn't squeak when it works normally.

JMP · Mar 14, 2002

Mario

A little bit of knowledge is indeed a dangerous thing. Instead of asking for advice on a BB like this........ my suggestion would be to GO TO A DR. OR NURSE PRACTIONER with any MEDICAL concern. Let's face it, none of us can hear it, see you or give a proper evaulation. But, it is one way to get attention.

hoolahan, ASN, RN · Mar 14, 2002

I like the song idea, instead of "Your cheating heart," make it

"Your squeaking heart.....will tell on you....you'll try and try....to make it new....but valves and discs....they wear out too.....your squeaking heart....will tell on you"

{Hoolahan takes a bow while the dog howls mournfully in the background}

SICU Queen · Mar 14, 2002

I wish I had as much time as Mario.

mattcastens · Mar 14, 2002

Originally posted by mario_ragucci
Thanks Matt - I'm going to keep your responce because it explains so much. Did you look up this information you passed on to me, or is it from your experience? It sounds like the kinds of answers I'd, one day, like to belt out to someone who asks me a similiar question. I'll print your responce, and then try to draw a picture of a sleeping heart, with he information you have so wonderfully given. Really, how did you know these answers so well?

Some of it is from experience, some of it is from studying, a lot of it is from asking questions. We are all continually learning.

mario_ragucci · Mar 14, 2002

Damn Hoolahan ! That is an excellent rendition of Hank Williams, Sr. What about: "How can I free my sleeping mind, and awaken my squeak, squeakin' heart"

Yes: "Owner of a squeakin' heart, much better than a owner of a growling heart"

Neil Young - (harmonica intro) "it keeps me searching for a heart that squeaks - and i'm getting old - i've been a miner for a heart that squeaks"

SICU Queen - Time is not an object you can have more or less of. You can't possess time; Time is a sense. You can't store time in a bottle. You can't give time. You can experience time. There is no way I can "have" more time than you, or anybody. We all experience time at exactly the same rate. Our senses can not come near the speed of time, which is, the speed of light. Meet me tonight and the nearest event horizon, and I'll show you :-)

Rod Stewart - "Young Turks"

"Young hearts, they squeak this morning, time is on your side, don't ever squeak them down, don't let them squeak you around, don't ever let them squeak your point of view......Because life is so brief, and TIME is a thief, when your undecided....and like a fist full of sand it can sift right through your hands.....yeah!....Young hearts, they squeak tonight!!!!!:kiss