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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 ...
Hypertrophic cardiomyopathy (HCM, or HOCM when obstructive) is a condition in which muscle tissues of the heart become thickened without an obvious cause. [8] The parts of the heart most commonly affected are the interventricular septum and the ventricles . [ 10 ]
Can be due to aortic valve stenosis or hypertrophic cardiomyopathy (HCM), with a harsh and rough quality. ** Valvular aortic stenosis can produce a harsh, or even a musical murmur over the right second intercostal space which radiates into the neck over the two carotid arteries.
] For example, the Valsalva maneuver (phase II) increases the intensity of hypertrophic cardiomyopathy murmurs, namely those of dynamic subvalvular left ventricular outflow obstruction. This is due to the decreased preload in this phase, worsening the obstruction and thus accentuating the murmur. [3]
Mitral valve prolapse: The click and the murmur of mitral valve prolapse are delayed because left atrial volume also increases due to mitral regurgitation along with increased left ventricular volume. [5] Murmurs that are due to forward flowing of blood such as aortic stenosis, and hypertrophic cardiomyopathy decrease in intensity. [4]
In contrast to most other heart murmurs, the murmur of mitral valve prolapse is accentuated by standing and Valsalva maneuver (earlier systolic click and longer murmur) and diminished with squatting (later systolic click and shorter murmur). The only other heart murmur that follows this pattern is the murmur of hypertrophic cardiomyopathy. An ...
On physical examination, the most prominent features are due to the development of right-sided heart failure. These can include a raised jugular venous pressure, ascites, left parasternal heave and a tender, enlarged liver on palpation. [3] On inspection, patients may be chronically ill, cyanotic, cachectic and occasionally jaundiced. [citation ...
Split during expiration: Reverse splitting (paradoxical splitting) indicates pathology due to delay of aortic valve closing. Aortic stenosis, hypertrophic cardiomyopathy, left bundle branch block (LBBB), and a ventricular pacemaker could all cause a reverse splitting of the second heart sound. [4] Split during both inspiration and expiration: