Heart murmur history and symptoms: Difference between revisions

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{{Heart murmur}}
{{CMG}}; {{AE}}{{nuha}}
 
==Overview==
Many times, the person experiencing [[heart murmur]] may not be aware of anything. But [[heart murmur]] can be associated with other things such as [[chest pain|tightness in the chest]], [[shortness of breath]], [[dizziness]] or [[lightheadedness]]. Depending on the cause of the murmur, these symptoms may be different.
 
==History and Symptoms==
 
* The symptoms of heart murmur depend on the cause of the murmur.
 
{| class="wikitable"
|+
! rowspan="2" |Disease
! colspan="2" |Clinical features
|-
|'''Signs'''
|'''Symptoms'''
|-
| text-align: center;" |[[Aortic stenosis]]
| text-align: center;" |<small>Vitals</small>
*<small>[[Narrow pulse pressure]].<ref name="pmid15710699">{{cite journal| author=Bermejo J| title=The effects of hypertension on aortic valve stenosis. | journal=Heart | year= 2005 | volume= 91 | issue= 3 | pages= 280-2 | pmid=15710699 | doi=10.1136/hrt.2004.041749 | pmc=1768786 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15710699  }}</ref><ref>{{Cite journal
| author = [[J. BERGERON]], [[W. H. ABELMANN]], [[H. VAZQUEZ-MILAN]] & [[L. B. ELLIS]]
| title = Aortic stenosis; clinical manifestations and course of the disease; review of one hundred proved cases
| journal = [[A.M.A. archives of internal medicine]]
| volume = 94
| issue = 6
| pages = 911–924
| year = 1954
| month = December
| pmid = 13217489
}}</ref></small>
 
*<small>[[Pulsus parvus et tardus]].<ref name="pmid90321642">{{cite journal |author=Etchells E, Bell C, Robb K |title=Does this patient have an abnormal systolic murmur? |journal=[[JAMA : the Journal of the American Medical Association]] |volume=277 |issue=7 |pages=564–71 |year=1997 |month=February |pmid=9032164 |doi= |url= |accessdate=2012-04-09}}</ref></small>
*<small>[[Pulsus bisferiens]] with mixed [[aortic stenosis]] and [[aortic regurgitation]].<ref name="pmid134718182">{{cite journal| author=FLEMING PR| title=The mechanism of the pulsus bisferiens. | journal=Br Heart J | year= 1957 | volume= 19 | issue= 4 | pages= 519-24 | pmid=13471818 | doi= | pmc=503962 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13471818  }}</ref></small>
*<small>Delayed carotid upstroke (apical-carotid delay) is present. <ref>{{Cite journal
| author = [[Blase A. Carabello]] & [[Walter J. Paulus]]
| title = Aortic stenosis
| journal = [[Lancet (London, England)]]
| volume = 373
| issue = 9667
| pages = 956–966
| year = 2009
| month = March
| doi = 10.1016/S0140-6736(09)60211-7
| pmid = 19232707
}}</ref></small>
*<small>[[Pulsus alternans]].<ref>{{Cite journal
| author = [[R. H. Swanton]], [[B. S. Jenkins]], [[I. A. Brooksby]] & [[M. M. Webb-Peploe]]
| title = An analysis of pulsus alternans in aortic stenosis
| journal = [[European journal of cardiology]]
| volume = 4
| issue = 1
| pages = 39–47
| year = 1976
| month = March
| pmid = 1261578
}}</ref></small>
 
<small>Heart</small>
 
*<small>laterally displaced [[apical impulse]].<ref>{{Cite journal
| author = [[S. J. Galloway]], [[W. J. Casarella]] & [[P. M. Shimkin]]
| title = Vascular malformations of the right colon as a cause of bleeding in patients with aortic stenosis
| journal = [[Radiology]]
| volume = 113
| issue = 1
| pages = 11–15
| year = 1974
| month = October
| doi = 10.1148/113.1.11
| pmid = 4547644
}}</ref><ref name="pmid204358422">{{cite journal| author=Maganti K, Rigolin VH, Sarano ME, Bonow RO| title=Valvular heart disease: diagnosis and management. | journal=Mayo Clin Proc | year= 2010 | volume= 85 | issue= 5 | pages= 483-500 | pmid=20435842 | doi=10.4065/mcp.2009.0706 | pmc=2861980 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20435842  }}</ref></small>
 
*<small>[[thrill|Systolic thrill]] at the right second intercostal space, in the jugular notch and along the [[carotid arteries]].<ref>{{Cite journal
| author = [[S. J. Galloway]], [[W. J. Casarella]] & [[P. M. Shimkin]]
| title = Vascular malformations of the right colon as a cause of bleeding in patients with aortic stenosis
| journal = [[Radiology]]
| volume = 113
| issue = 1
| pages = 11–15
| year = 1974
| month = October
| doi = 10.1148/113.1.11
| pmid = 4547644
}}</ref></small>
*<small>paradoxical splitting of S2 is present with [[A2]] taking place after P2..<ref>{{Cite journal
| author = [[Ilias Maglogiannis]], [[Euripidis Loukis]], [[Elias Zafiropoulos]] & [[Antonis Stasis]]
| title = Support Vectors Machine-based identification of heart valve diseases using heart sounds
| journal = [[Computer methods and programs in biomedicine]]
| volume = 95
| issue = 1
| pages = 47–61
| year = 2009
| month = July
| doi = 10.1016/j.cmpb.2009.01.003
| pmid = 19269056
}}</ref><ref name="pmid204358422" /><ref>{{Cite journal
| author = [[Chance M. Witt]], [[William R. Miranda]] & [[Darrell B. Newman]]
| title = The maverick heart sound
| journal = [[Heart (British Cardiac Society)]]
| volume = 102
| issue = 13
| pages = 1008
| year = 2016
| month = July
| doi = 10.1136/heartjnl-2015-309131
| pmid = 26919867
}}</ref></small>
*<small>the murmur is Crescendo-decrescendo type of [[ejection systolic murmur]].<ref>{{Cite journal
| author = [[Atsuko Furukawa]], [[Yukio Abe]], [[Makoto Ito]], [[Chiharu Tanaka]], [[Kazato Ito]], [[Ryushi Komatsu]], [[Kazuo Haze]], [[Takahiko Naruko]], [[Minoru Yoshiyama]] & [[Junichi Yoshikawa]]
| title = Prediction of aortic stenosis-related events in patients with systolic ejection murmur using pocket-sized echocardiography
| journal = [[Journal of cardiology]]
| volume = 69
| issue = 1
| pages = 189–194
| year = 2017
| month = January
| doi = 10.1016/j.jjcc.2016.02.021
| pmid = 27012751
}}</ref><ref name="pmid204358422" /></small>
 
<small>Lungs</small>
 
*<small>In a patient with [[Aortic Stenosis]], [[Rales|Pulmonary rales]] may be present when [[congestive heart failure]] has developed.<ref>{{Cite journal
| author = [[Lennart van Gils]], [[Marie-Annick Clavel]], [[Mara Vollema]], [[Victoria Delgado]], [[Tamim Nazif]], [[Ernest Spitzer]], [[Rebecca Hahn]], [[Jeroen Bax]], [[Martin Leon]], [[Philippe Pibarot]] & [[Nicolas Van Mieghem]]
| title = TCT-819 Clinical Outcome in Patients with Heart Failure and Moderate Aortic Stenosis
| journal = [[Journal of the American College of Cardiology]]
| volume = 68
| issue = 18S
| pages = B331–B332
| year = 2016
| month = November
| doi = 10.1016/j.jacc.2016.09.910
| pmid = 27970209
}}</ref><ref name="pmid48941512">{{cite journal| author=Ross J, Braunwald E| title=Aortic stenosis. | journal=Circulation | year= 1968 | volume= 38 | issue= 1 Suppl | pages= 61-7 | pmid=4894151 | doi= | pmc= | url= }}</ref><ref name="pmid204358422" /></small>
| text-align: center;" |<small>Symptoms by Age Group</small>
 
<small>Symptoms in Adults<ref name="pmid204241502">{{cite journal| author=Rajani R, Rimington H, Chambers JB| title=Treadmill exercise in apparently asymptomatic patients with moderate or severe aortic stenosis: relationship between cardiac index and revealed symptoms. | journal=Heart | year= 2010 | volume= 96 | issue= 9 | pages= 689-95 | pmid=20424150 | doi=10.1136/hrt.2009.181644 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20424150  }}</ref><ref name="pmid115596732">{{cite journal| author=Amato MC, Moffa PJ, Werner KE, Ramires JA| title=Treatment decision in asymptomatic aortic valve stenosis: role of exercise testing. | journal=Heart | year= 2001 | volume= 86 | issue= 4 | pages= 381-6 | pmid=11559673 | doi= | pmc=1729928 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11559673  }}</ref><ref name="pmid110294802">{{cite journal| author=Das P, Pocock C, Chambers J| title=The patient with a systolic murmur: severe aortic stenosis may be missed during cardiovascular examination. | journal=QJM | year= 2000 | volume= 93 | issue= 10 | pages= 685-8 | pmid=11029480 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11029480  }}</ref><ref name="pmid234895262">{{cite journal| author=Park SJ, Enriquez-Sarano M, Chang SA, Choi JO, Lee SC, Park SW et al.| title=Hemodynamic patterns for symptomatic presentations of severe aortic stenosis. | journal=JACC Cardiovasc Imaging | year= 2013 | volume= 6 | issue= 2 | pages= 137-46 | pmid=23489526 | doi=10.1016/j.jcmg.2012.10.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23489526  }}</ref></small>
 
*<small>[[Breathlessness]] with activity</small>
*<small>[[Chest pain]], which resembles what is known as [[angina]]-type pain</small>
**<small>The pain is crushing, squeezing, pressure or tightness in nature</small>
**<small>The pain increases with exercise, relieved with rest.</small>
*<small>[[Fainting]], [[weakness]], or [[dizziness]] with activity</small>
*<small>[[Sensation of feeling the heart beat]] ([[palpitations]])</small>
 
<small>Symptoms in Infants and Children</small>
 
<small>The following symptoms were observed in infants and children with [[aortic stenosis]].<ref name="pmid60207392">{{cite journal| author=Mody MR, Nadas AS, Bernhard WF| title=Aortic stenosis in infants. | journal=N Engl J Med | year= 1967 | volume= 276 | issue= 15 | pages= 832-8 | pmid=6020739 | doi=10.1056/NEJM196704132761503 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6020739  }}</ref><ref name="pmid135050142">{{cite journal| author=ONGLEY PA, NADAS AS, PAUL MH, RUDOLPH AM, STARKEY GW| title=Aortic stenosis in infants and children. | journal=Pediatrics | year= 1958 | volume= 21 | issue= 2 | pages= 207-21 | pmid=13505014 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13505014 }}</ref><ref name="pmid218294082">{{cite journal| author=Yun SW| title=Congenital heart disease in the newborn requiring early intervention. | journal=Korean J Pediatr | year= 2011 | volume= 54 | issue= 5 | pages= 183-91 | pmid=21829408 | doi=10.3345/kjp.2011.54.5.183 | pmc=3145901 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21829408  }}</ref></small>
 
*<small>Becoming tired or [[fatigue]]d with exertion more easily than others (in mild cases)</small>
*<small>Serious breathing problems that develop within days or weeks of birth (in severe cases)</small>
*<small>Extreme [[fatigue]]</small>
*<small>[[Sweating]]</small>
*<small>Pale skin</small>
*[[Fast breathing|<small>Fast breathing</small>]]
*<small>They may also be [[smaller than other children their age]]</small>
*<small>Children with mild or moderate aortic stenosis may get worse as they get older. They also run the risk of developing an infection of the heart valves ([[bacterial endocarditis]]).</small>
|-
|[[MS]]
|<small>'''heart'''<ref name="pmid22379596">{{cite journal| author=Nassar PN, Hamdan RH| title=Cor Triatriatum Sinistrum: Classification and Imaging Modalities. | journal=Eur J Cardiovasc Med | year= 2011 | volume= 1 | issue= 3 | pages= 84-87 | pmid=22379596 | doi=10.5083/ejcm.20424884.21 | pmc=3286827 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22379596  }}</ref><ref name="pmid17170355">{{cite journal| author=Roudaut R, Serri K, Lafitte S| title=Thrombosis of prosthetic heart valves: diagnosis and therapeutic considerations. | journal=Heart | year= 2007 | volume= 93 | issue= 1 | pages= 137-42 | pmid=17170355 | doi=10.1136/hrt.2005.071183 | pmc=1861363 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17170355  }}</ref><ref name="pmid19604402">{{cite journal| author=Apostolakis EE, Baikoussis NG| title=Methods of estimation of mitral valve regurgitation for the cardiac surgeon. | journal=J Cardiothorac Surg | year= 2009 | volume= 4 | issue=  | pages= 34 | pmid=19604402 | doi=10.1186/1749-8090-4-34 | pmc=2723095 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19604402 }}</ref></small>
*[[JVD|<small>Jugular vein distension</small>]]
 
*<small>Apical impulse displaced laterally or not palpable</small>
 
*<small>Diastolic thrill at the apex</small>
 
*<small>Signs of heart failure in severe case</small>
*<small>the murmur will be Diastolic murmur, Low pitched, Opening snap followed by decrescendo-crescendo rumbling murmur.</small>
|
*[[Dyspnea on exertion]]
 
*[[Paroxysmal nocturnal dyspnea]]
 
*[[Orthopnea]]
 
*New onset [[atrial fibrillation]]
|-
|[[Mitral regurgitation]]
|
|<small>Acute or Decompensated Mitral Regurgitation</small>
 
* <small>volume overload with subsequent [[pulmonary congestion]] in addition to the decreased [[cardiac output]].  Symptoms include:<ref name="pmid19356795">{{cite journal| author=Enriquez-Sarano M, Akins CW, Vahanian A| title=Mitral regurgitation. | journal=Lancet | year= 2009 | volume= 373 | issue= 9672 | pages= 1382-94 | pmid=19356795 | doi=10.1016/S0140-6736(09)60692-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19356795  }}</ref><ref name="pmid12436029">{{cite journal| author=Birnbaum Y, Chamoun AJ, Conti VR, Uretsky BF| title=Mitral regurgitation following acute myocardial infarction. | journal=Coron Artery Dis | year= 2002 | volume= 13 | issue= 6 | pages= 337-44 | pmid=12436029 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12436029  }}</ref><ref name="pmid12639884">{{cite journal| author=Iung B| title=Management of ischaemic mitral regurgitation. | journal=Heart | year= 2003 | volume= 89 | issue= 4 | pages= 459-64 | pmid=12639884 | doi= | pmc=1769268 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12639884  }}</ref></small>
**[[Shortness of breath|<small>Shortness of breath</small>]]
**<small>[[Orthopnea]]</small>
**[[Paroxysmal nocturnal dyspnea|<small>Paroxysmal nocturnal dyspnea</small>]]
**[[Exercise intolerance|<small>Exercise intolerance</small>]]
**<small>[[Fatigue]]</small>
**<small>[[Lightheadedness]]</small>
**<small>[[Cough]]</small>
*<small>Cardiovascular collapse with [[Shock (medical)|shock]] ([[cardiogenic shock]]).</small>
 
====<small>Chronic Compensated Mitral Regurgitation</small>====
 
*<small>Individuals with chronic compensated MR may be asymptomatic, with a normal exercise tolerance and no evidence of [[heart failure]].</small>  
*<small>[[Palpitations]] due to the dilatation of the [[left atrium]].<ref name="pmid24672698">{{cite journal| author=Madesis A, Tsakiridis K, Zarogoulidis P, Katsikogiannis N, Machairiotis N, Kougioumtzi I et al.| title=Review of mitral valve insufficiency: repair or replacement. | journal=J Thorac Dis | year= 2014 | volume= 6 Suppl 1 | issue=  | pages= S39-51 | pmid=24672698 | doi=10.3978/j.issn.2072-1439.2013.10.20 | pmc=3966162 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24672698  }}</ref><ref name="pmid22961273">{{cite journal| author=Sparano DM, Ward RP| title=Management of asymptomatic, severe mitral regurgitation. | journal=Curr Treat Options Cardiovasc Med | year= 2012 | volume= 14 | issue= 6 | pages= 575-83 | pmid=22961273 | doi=10.1007/s11936-012-0207-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22961273  }}</ref><ref name="pmid21423463">{{cite journal| author=Mokadam NA, Stout KK, Verrier ED| title=Management of acute regurgitation in left-sided cardiac valves. | journal=Tex Heart Inst J | year= 2011 | volume= 38 | issue= 1 | pages= 9-19 | pmid=21423463 | doi= | pmc=3060740 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21423463  }}</ref></small>
|}<br />
{{Heart murmur}}
{{Heart murmur}}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
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[[Category:Physical examination]]
[[Category:Physical examination]]
[[Category:Mature chapter]]
[[Category:Mature chapter]]
[[Category:Primary care]]
[[Category:Needs content]]
[[Category:Needs content]]
{{WH}}
{{WS}}

Latest revision as of 11:40, 27 October 2020

Heart murmur Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Echocardiography

Treatment

Medical Therapy

Case Studies

Case #1

Heart murmur history and symptoms On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Heart murmur history and symptoms

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Heart murmur history and symptoms

CDC on Heart murmur history and symptoms

Heart murmur history and symptoms in the news

Blogs on Heart murmur history and symptoms

Directions to Hospitals Treating Heart murmur

Risk calculators and risk factors for Heart murmur history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nuha Al-Howthi, MD[2]

Overview

Many times, the person experiencing heart murmur may not be aware of anything. But heart murmur can be associated with other things such as tightness in the chest, shortness of breath, dizziness or lightheadedness. Depending on the cause of the murmur, these symptoms may be different.

History and Symptoms

  • The symptoms of heart murmur depend on the cause of the murmur.
Disease Clinical features
Signs Symptoms
Aortic stenosis Vitals

Heart

Lungs

Symptoms by Age Group

Symptoms in Adults[15][16][17][18]

Symptoms in Infants and Children

The following symptoms were observed in infants and children with aortic stenosis.[19][20][21]

MS heart[22][23][24]
  • Apical impulse displaced laterally or not palpable
  • Diastolic thrill at the apex
  • Signs of heart failure in severe case
  • the murmur will be Diastolic murmur, Low pitched, Opening snap followed by decrescendo-crescendo rumbling murmur.
Mitral regurgitation Acute or Decompensated Mitral Regurgitation

Chronic Compensated Mitral Regurgitation


Heart murmur Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Echocardiography

Treatment

Medical Therapy

Case Studies

Case #1

Heart murmur history and symptoms On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Heart murmur history and symptoms

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Heart murmur history and symptoms

CDC on Heart murmur history and symptoms

Heart murmur history and symptoms in the news

Blogs on Heart murmur history and symptoms

Directions to Hospitals Treating Heart murmur

Risk calculators and risk factors for Heart murmur history and symptoms

References

  1. Bermejo J (2005). "The effects of hypertension on aortic valve stenosis". Heart. 91 (3): 280–2. doi:10.1136/hrt.2004.041749. PMC 1768786. PMID 15710699.
  2. J. BERGERON, W. H. ABELMANN, H. VAZQUEZ-MILAN & L. B. ELLIS (1954). "Aortic stenosis; clinical manifestations and course of the disease; review of one hundred proved cases". A.M.A. archives of internal medicine. 94 (6): 911–924. PMID 13217489. Unknown parameter |month= ignored (help)
  3. Etchells E, Bell C, Robb K (1997). "Does this patient have an abnormal systolic murmur?". JAMA : the Journal of the American Medical Association. 277 (7): 564–71. PMID 9032164. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  4. FLEMING PR (1957). "The mechanism of the pulsus bisferiens". Br Heart J. 19 (4): 519–24. PMC 503962. PMID 13471818.
  5. Blase A. Carabello & Walter J. Paulus (2009). "Aortic stenosis". Lancet (London, England). 373 (9667): 956–966. doi:10.1016/S0140-6736(09)60211-7. PMID 19232707. Unknown parameter |month= ignored (help)
  6. R. H. Swanton, B. S. Jenkins, I. A. Brooksby & M. M. Webb-Peploe (1976). "An analysis of pulsus alternans in aortic stenosis". European journal of cardiology. 4 (1): 39–47. PMID 1261578. Unknown parameter |month= ignored (help)
  7. S. J. Galloway, W. J. Casarella & P. M. Shimkin (1974). "Vascular malformations of the right colon as a cause of bleeding in patients with aortic stenosis". Radiology. 113 (1): 11–15. doi:10.1148/113.1.11. PMID 4547644. Unknown parameter |month= ignored (help)
  8. 8.0 8.1 8.2 8.3 Maganti K, Rigolin VH, Sarano ME, Bonow RO (2010). "Valvular heart disease: diagnosis and management". Mayo Clin Proc. 85 (5): 483–500. doi:10.4065/mcp.2009.0706. PMC 2861980. PMID 20435842.
  9. S. J. Galloway, W. J. Casarella & P. M. Shimkin (1974). "Vascular malformations of the right colon as a cause of bleeding in patients with aortic stenosis". Radiology. 113 (1): 11–15. doi:10.1148/113.1.11. PMID 4547644. Unknown parameter |month= ignored (help)
  10. Ilias Maglogiannis, Euripidis Loukis, Elias Zafiropoulos & Antonis Stasis (2009). "Support Vectors Machine-based identification of heart valve diseases using heart sounds". Computer methods and programs in biomedicine. 95 (1): 47–61. doi:10.1016/j.cmpb.2009.01.003. PMID 19269056. Unknown parameter |month= ignored (help)
  11. Chance M. Witt, William R. Miranda & Darrell B. Newman (2016). "The maverick heart sound". Heart (British Cardiac Society). 102 (13): 1008. doi:10.1136/heartjnl-2015-309131. PMID 26919867. Unknown parameter |month= ignored (help)
  12. Atsuko Furukawa, Yukio Abe, Makoto Ito, Chiharu Tanaka, Kazato Ito, Ryushi Komatsu, Kazuo Haze, Takahiko Naruko, Minoru Yoshiyama & Junichi Yoshikawa (2017). "Prediction of aortic stenosis-related events in patients with systolic ejection murmur using pocket-sized echocardiography". Journal of cardiology. 69 (1): 189–194. doi:10.1016/j.jjcc.2016.02.021. PMID 27012751. Unknown parameter |month= ignored (help)
  13. Lennart van Gils, Marie-Annick Clavel, Mara Vollema, Victoria Delgado, Tamim Nazif, Ernest Spitzer, Rebecca Hahn, Jeroen Bax, Martin Leon, Philippe Pibarot & Nicolas Van Mieghem (2016). "TCT-819 Clinical Outcome in Patients with Heart Failure and Moderate Aortic Stenosis". Journal of the American College of Cardiology. 68 (18S): B331–B332. doi:10.1016/j.jacc.2016.09.910. PMID 27970209. Unknown parameter |month= ignored (help)
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