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Heart Murmur

Leon D. Sanchez, Francis J. O’Connell
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  • Description
  • Etiology


  • Signs and Symptoms
  • Essential Workup
  • Tests
  • Differential Diagnosis


  • Pre-hospital
  • Initial Stabilization
  • ED Treatment
  • Medication (Drugs)
  • In-patient Considerations


  • Follow-Up Recommendations
The following is an excerpt....
  • Sounds created by physiologic processes or functional and structural anomalies of the heart.
  • Stenotic lesions:
    • Pressure overload in the chamber preceding the valve, leading to hypertrophy of the chamber in an attempt to overcome the increased resistance
  • Regurgitant lesions:
    • Volume overload of the chamber preceding the valve, leading to chamber dilatation in an attempt to accommodate the regurgitant blood volume.
  • Genetic abnormalities:
    • Congenital defects because of abnormal cardiac blood flow
  • Aortic stenosis:
    • Rheumatic heart disease
    • Congenital bicuspid valve
    • Calcification of valve from aging
    • Prosthetic valve
  • Aortic regurgitation:
    • Rheumatic heart disease
    • Endocarditis
    • Aortic dissection
    • Prosthetic valve
  • Mitral stenosis:
    • Rheumatic heart disease
    • Rheumatologic disorders (systemic lupus erythematosus)
    • Calcification
    • Cardiac tumors (atrial myxoma)
    • Congenital
    • Prosthetic valve
  • Mitral regurgitation, acute:
    • Endocarditis ...

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See Also
Images >
1 2
A case of complex congenital heart disease. Patient has situs inversus, dextrocardia, is status-post tetralogy of Fallot repair, and presents with symptoms of right-sided heart failure. A: Axial gradient echo images showing dextrocardia and right ventricular dilation. B: Sagittal gradient-echo images showing free pulmonary regurgitation (arrow) at the site of previous infundibular resection.Credit: Topol EJ, Califf RM, etal. Textbook of Cardiovascular Medicine, 3rd Edition. Philadelphia: Lippincott Williams & Wilkins, 2006.
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