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Finally, aortic stenosis often co-exists with some degree of aortic insufficiency (aortic regurgitation). Hence, the physical exam in aortic stenosis may also reveal signs of the latter, for example, an early diastolic decrescendo murmur.
De Musset's sign is a type of rhythmic bobbing of the head in synchrony with the beating of the heart, seen in severe aortic regurgitation. [1]This sign occurs as a result of blood from the aorta regurgitating into the left ventricle due to a defect in the aortic valve.
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]
It sometimes radiates to the carotid arteries. In mild aortic stenosis, the crescendo-decrescendo is early peaking. Whereas in severe aortic stenosis, the crescendo is late-peaking. In severe cases, obliteration of the S2 heart sound may occur. Stenosis of Bicuspid aortic valve is like the aortic valve stenosis heart murmur. But, one may hear a ...
aortic arch dilatation or aneurysm, mediastinal tumour: left displacement of trachea elicits palpable pulsation of same Carey Coombs murmur: Carey Coombs: cardiology, rheumatology: rheumatic fever: mid-diastolic rumble Carnett's sign: John Berton Carnett: primary care, surgery: abdominal mass and/or pain: Am J Med Sci 174 (1927): 579–599
The effect of reducing the intensity in forward flowing murmurs is much more evident in aortic stenosis rather than mitral stenosis. The reason for this is that there is a larger pressure gradient across the aortic valve. [6] A complementary maneuver for differentiating disorders is the Valsalva maneuver, which decreases preload. [7]
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