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The murmur in HCM increases in intensity with a standing position as well as straining with Valsalva maneuver. Mid-systolic ejection Pulmonic outflow obstruction (Pulmonic stenosis) A harsh murmur usually on left second intercostal space radiating to left neck and accompanied by palpable thrill.
Associated with aortic valve regurgitation (or mitral regurgitation before rupture of chordae). It is a diastolic murmur heard over the mid-precordium. [16] Continuous and Combined Systolic/Diastolic. Patent ductus arteriosus may present as a continuous murmur radiating to the back. Severe coarctation of the aorta can present with a continuous ...
Many carotid bruits are discovered incidentally in an otherwise asymptomatic patient. The presence of a carotid bruit alone does not necessarily indicate the presence of stenosis, and the physical examination cannot be used to estimate the degree of stenosis, if present; therefore, any bruit must be evaluated by ultrasound or imaging. [4]
According to a meta-analysis, the most useful findings for ruling in aortic stenosis in the clinical setting were slow rate of rise of the carotid pulse (positive likelihood ratio ranged 2.8–130 across studies), mid to late peak intensity of the murmur (positive likelihood ratio, 8.0–101), and decreased intensity of the second heart sound ...
The presence of a murmur at the apex can be misinterpreted as mitral regurgitation. However, the apical murmur of the Gallavardin phenomenon does not radiate to the left axilla and is accentuated by a slowing of the heart rate (such as a compensatory pause after a premature beat) whereas the mitral regurgitation murmur does not change. [2]
Still's murmur is detected via auscultation with a stethoscope.It has a peculiar "musical", "resonant" or "vibratory" quality that is quite unique. [1] [2] It is generally most easily heard at the left middle or lower sternal border and the right upper sternal border, often with radiation to the carotid arteries, although other locations are common.
The murmur usually does not extend to S1. Early diastolic Left anterior descending artery stenosis This murmur, also known as Dock's murmur, is similar to that of aortic regurgitation and is heard at the left second or third intercostal space. A Coronary artery bypass surgery can eliminate the murmur. Early diastolic Cabot–Locke murmur
Stenosis of the aortic valve produces a harsh systolic murmur that classically radiates in the carotid arteries as well as pulsus parvus et tardus. Aortic valve replacement – Replacement of the aortic valve due to aortic regurgitation , aortic stenosis , or other reasons.