Heart murmur history and symptoms: Difference between revisions

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__NOTOC__
{{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"
{| class="wikitable"
|+
|+
! rowspan="2" |{{fontcolor|#FFF|Disease}}
! rowspan="2" |Disease
! colspan="5" |{{fontcolor|#FFF|Clinical features}}
! colspan="2" |Clinical features
|-
|-
| colspan="4" |{{fontcolor|#FFF|'''Signs'''}}
|'''Signs'''
|{{fontcolor|#FFF|'''Symptoms'''}}
|'''Symptoms'''
|-
|-
| text-align: center;" |[[Aortic stenosis]]
| text-align: center;" |[[Aortic stenosis]]
| colspan="4" text-align: center;" |
| text-align: center;" |<small>Vitals</small>
===Vitals===
*<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
 
*[[Narrow pulse pressure]]: The systolic pressure may decrease and narrow [[pulse pressure]] may be present.<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]]
  | 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
  | title = Aortic stenosis; clinical manifestations and course of the disease; review of one hundred proved cases
Line 23: Line 30:
  | month = December
  | month = December
  | pmid = 13217489
  | pmid = 13217489
}}</ref>
}}</ref></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>[[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>
*[[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>[[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>
*Delayed carotid upstroke (apical-carotid delay) is present. <ref>{{Cite journal
*<small>Delayed carotid upstroke (apical-carotid delay) is present. <ref>{{Cite journal
  | author = [[Blase A. Carabello]] & [[Walter J. Paulus]]
  | author = [[Blase A. Carabello]] & [[Walter J. Paulus]]
  | title = Aortic stenosis
  | title = Aortic stenosis
Line 38: Line 45:
  | doi = 10.1016/S0140-6736(09)60211-7
  | doi = 10.1016/S0140-6736(09)60211-7
  | pmid = 19232707
  | pmid = 19232707
}}</ref>  
}}</ref></small>
*[[Pulsus alternans]].<ref>{{Cite journal
*<small>[[Pulsus alternans]].<ref>{{Cite journal
  | author = [[R. H. Swanton]], [[B. S. Jenkins]], [[I. A. Brooksby]] & [[M. M. Webb-Peploe]]
  | author = [[R. H. Swanton]], [[B. S. Jenkins]], [[I. A. Brooksby]] & [[M. M. Webb-Peploe]]
  | title = An analysis of pulsus alternans in aortic stenosis
  | title = An analysis of pulsus alternans in aortic stenosis
Line 49: Line 56:
  | month = March
  | month = March
  | pmid = 1261578
  | pmid = 1261578
}}</ref>
}}</ref></small>


===Heart===
<small>Heart</small>


*laterally displaced [[apical impulse]].<ref>{{Cite journal
*<small>laterally displaced [[apical impulse]].<ref>{{Cite journal
  | author = [[S. J. Galloway]], [[W. J. Casarella]] & [[P. M. Shimkin]]
  | 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
  | title = Vascular malformations of the right colon as a cause of bleeding in patients with aortic stenosis
Line 64: Line 71:
  | doi = 10.1148/113.1.11
  | doi = 10.1148/113.1.11
  | pmid = 4547644
  | 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>  
}}</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>


*[[thrill|Systolic thrill]] at the right second intercostal space, in the jugular notch and along the [[carotid arteries]].<ref>{{Cite journal
*<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]]
  | 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
  | title = Vascular malformations of the right colon as a cause of bleeding in patients with aortic stenosis
Line 77: Line 84:
  | doi = 10.1148/113.1.11
  | doi = 10.1148/113.1.11
  | pmid = 4547644
  | pmid = 4547644
}}</ref>
}}</ref></small>
*paradoxical splitting of S2 is present with [[A2]] taking place after P2..<ref>{{Cite journal
*<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]]
  | author = [[Ilias Maglogiannis]], [[Euripidis Loukis]], [[Elias Zafiropoulos]] & [[Antonis Stasis]]
  | title = Support Vectors Machine-based identification of heart valve diseases using heart sounds
  | title = Support Vectors Machine-based identification of heart valve diseases using heart sounds
Line 100: Line 107:
  | doi = 10.1136/heartjnl-2015-309131
  | doi = 10.1136/heartjnl-2015-309131
  | pmid = 26919867
  | pmid = 26919867
}}</ref>
}}</ref></small>
*[[S4]], [[S3]].
*<small>the murmur is Crescendo-decrescendo type of [[ejection systolic murmur]].<ref>{{Cite journal
*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]]
  | 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
  | title = Prediction of aortic stenosis-related events in patients with systolic ejection murmur using pocket-sized echocardiography
Line 113: Line 119:
  | doi = 10.1016/j.jjcc.2016.02.021
  | doi = 10.1016/j.jjcc.2016.02.021
  | pmid = 27012751
  | pmid = 27012751
}}</ref><ref name="pmid204358422" />
}}</ref><ref name="pmid204358422" /></small>


===Lungs===
<small>Lungs</small>


*In a patient with [[Aortic Stenosis]], [[Rales|Pulmonary rales]] may be present when [[congestive heart failure]] has developed.<ref>{{Cite journal
*<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]]
  | 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
  | title = TCT-819 Clinical Outcome in Patients with Heart Failure and Moderate Aortic Stenosis
Line 128: Line 134:
  | doi = 10.1016/j.jacc.2016.09.910
  | doi = 10.1016/j.jacc.2016.09.910
  | pmid = 27970209
  | 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" />
}}</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>


===Extremeties===
<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>


*[[Peripheral edema]] may be present in a patient who subsequently develops [[congestive heart failure]].<ref>{{Cite journal
*<small>[[Breathlessness]] with activity</small>
| author = [[Michael Behnes]], [[Siegfried Lang]], [[Ole-A. Breithardt]], [[Jens J. Kaden]], [[Dariusch Haghi]], [[Parviz Ahmad-Nejad]], [[Elif Elmas]], [[Christian Wolpert]], [[Martin Borggrefe]], [[Michael Neumaier]] & [[Martina Brueckmann]]
*<small>[[Chest pain]], which resembles what is known as [[angina]]-type pain</small>
| title = Association of NT-proBNP with severity of heart valve disease in a medical patient population presenting with acute dyspnea or peripheral edema
**<small>The pain is crushing, squeezing, pressure or tightness in nature</small>
| journal = [[The Journal of heart valve disease]]
**<small>The pain increases with exercise, relieved with rest.</small>
| volume = 17
*<small>[[Fainting]], [[weakness]], or [[dizziness]] with activity</small>
| issue = 5
*<small>[[Sensation of feeling the heart beat]] ([[palpitations]])</small>
| pages = 557–565
| year = 2008
| month = September
| pmid = 18980090
}}</ref><ref name="pmid204358422" />
| text-align: center;" |
===Symptoms by Age Group===
====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>====


*[[Breathlessness]] with activity
<small>Symptoms in Infants and Children</small>
*[[Chest pain]], which resembles what is known as [[angina]]-type pain
**The pain is crushing, squeezing, pressure or tightness in nature
**The pain increases with exercise, relieved with rest.
*[[Fainting]], [[weakness]], or [[dizziness]] with activity
*[[Sensation of feeling the heart beat]] ([[palpitations]])


====Symptoms in Infants and Children====
<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>
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>


*Becoming tired or [[fatigue]]d with exertion more easily than others (in mild cases)
*<small>Becoming tired or [[fatigue]]d with exertion more easily than others (in mild cases)</small>
*Serious breathing problems that develop within days or weeks of birth (in severe cases)
*<small>Serious breathing problems that develop within days or weeks of birth (in severe cases)</small>
*Extreme [[fatigue]]
*<small>Extreme [[fatigue]]</small>
*[[Sweating]]
*<small>[[Sweating]]</small>
*Pale skin
*<small>Pale skin</small>
*[[Fast breathing]]
*[[Fast breathing|<small>Fast breathing</small>]]
*They may also be [[smaller than other children their age]]
*<small>They may also be [[smaller than other children their age]]</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>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]]
| colspan="4" |
|<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>
=== '''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> ===
*[[JVD|<small>Jugular vein distension</small>]]
 
* [[JVD|Jugular vein distension]]


* Apical impulse displaced laterally or not palpable
*<small>Apical impulse displaced laterally or not palpable</small>


* Diastolic thrill  at the apex
*<small>Diastolic thrill  at the apex</small>


* Signs of heart failure in severe case
*<small>Signs of heart failure in severe case</small>
* the murmur will be Diastolic murmur, Low pitched, Opening snap followed by decrescendo-crescendo rumbling murmur.
*<small>the murmur will be Diastolic murmur, Low pitched, Opening snap followed by decrescendo-crescendo rumbling murmur.</small>
|
|
* [[Dyspnea on exertion]]
*[[Dyspnea on exertion]]


* [[Paroxysmal nocturnal dyspnea]]
*[[Paroxysmal nocturnal dyspnea]]


* [[Orthopnea]]
*[[Orthopnea]]


* New onset [[atrial fibrillation]]
*New onset [[atrial fibrillation]]
|-
|-
|[[Mitral regurgitation]]
|
|
| colspan="4" | +
|<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>
| colspan="4" | +
**[[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 />
|}<br />
{{Heart murmur}}
{{Heart murmur}}

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

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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)
  14. Ross J, Braunwald E (1968). "Aortic stenosis". Circulation. 38 (1 Suppl): 61–7. PMID 4894151.
  15. Rajani R, Rimington H, Chambers JB (2010). "Treadmill exercise in apparently asymptomatic patients with moderate or severe aortic stenosis: relationship between cardiac index and revealed symptoms". Heart. 96 (9): 689–95. doi:10.1136/hrt.2009.181644. PMID 20424150.
  16. Amato MC, Moffa PJ, Werner KE, Ramires JA (2001). "Treatment decision in asymptomatic aortic valve stenosis: role of exercise testing". Heart. 86 (4): 381–6. PMC 1729928. PMID 11559673.
  17. Das P, Pocock C, Chambers J (2000). "The patient with a systolic murmur: severe aortic stenosis may be missed during cardiovascular examination". QJM. 93 (10): 685–8. PMID 11029480.
  18. Park SJ, Enriquez-Sarano M, Chang SA, Choi JO, Lee SC, Park SW; et al. (2013). "Hemodynamic patterns for symptomatic presentations of severe aortic stenosis". JACC Cardiovasc Imaging. 6 (2): 137–46. doi:10.1016/j.jcmg.2012.10.013. PMID 23489526.
  19. Mody MR, Nadas AS, Bernhard WF (1967). "Aortic stenosis in infants". N Engl J Med. 276 (15): 832–8. doi:10.1056/NEJM196704132761503. PMID 6020739.
  20. ONGLEY PA, NADAS AS, PAUL MH, RUDOLPH AM, STARKEY GW (1958). "Aortic stenosis in infants and children". Pediatrics. 21 (2): 207–21. PMID 13505014.
  21. Yun SW (2011). "Congenital heart disease in the newborn requiring early intervention". Korean J Pediatr. 54 (5): 183–91. doi:10.3345/kjp.2011.54.5.183. PMC 3145901. PMID 21829408.
  22. Nassar PN, Hamdan RH (2011). "Cor Triatriatum Sinistrum: Classification and Imaging Modalities". Eur J Cardiovasc Med. 1 (3): 84–87. doi:10.5083/ejcm.20424884.21. PMC 3286827. PMID 22379596.
  23. Roudaut R, Serri K, Lafitte S (2007). "Thrombosis of prosthetic heart valves: diagnosis and therapeutic considerations". Heart. 93 (1): 137–42. doi:10.1136/hrt.2005.071183. PMC 1861363. PMID 17170355.
  24. Apostolakis EE, Baikoussis NG (2009). "Methods of estimation of mitral valve regurgitation for the cardiac surgeon". J Cardiothorac Surg. 4: 34. doi:10.1186/1749-8090-4-34. PMC 2723095. PMID 19604402.
  25. Enriquez-Sarano M, Akins CW, Vahanian A (2009). "Mitral regurgitation". Lancet. 373 (9672): 1382–94. doi:10.1016/S0140-6736(09)60692-9. PMID 19356795.
  26. Birnbaum Y, Chamoun AJ, Conti VR, Uretsky BF (2002). "Mitral regurgitation following acute myocardial infarction". Coron Artery Dis. 13 (6): 337–44. PMID 12436029.
  27. Iung B (2003). "Management of ischaemic mitral regurgitation". Heart. 89 (4): 459–64. PMC 1769268. PMID 12639884.
  28. Madesis A, Tsakiridis K, Zarogoulidis P, Katsikogiannis N, Machairiotis N, Kougioumtzi I; et al. (2014). "Review of mitral valve insufficiency: repair or replacement". J Thorac Dis. 6 Suppl 1: S39–51. doi:10.3978/j.issn.2072-1439.2013.10.20. PMC 3966162. PMID 24672698.
  29. Sparano DM, Ward RP (2012). "Management of asymptomatic, severe mitral regurgitation". Curr Treat Options Cardiovasc Med. 14 (6): 575–83. doi:10.1007/s11936-012-0207-4. PMID 22961273.
  30. Mokadam NA, Stout KK, Verrier ED (2011). "Management of acute regurgitation in left-sided cardiac valves". Tex Heart Inst J. 38 (1): 9–19. PMC 3060740. PMID 21423463.

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