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🌱 來自: approach to the patient with a heart murmur

Diastolic Murmurs

• Early Diastolic Murmurs
  • AR
    • Valvular: congenital (bicuspid valve), rheumatic deformity, endocarditis, prolapse, trauma, post-valvotomy
    • Dilation of valve ring: aorta dissection, annuloaortic ectasia, medial degeneration, hypertension, ankylosing spondylitis
    • Widening of commissures: syphilis
  • Pulmonic regurgitation
    • Valvular: post-valvotomy, endocarditis, rheumatic fever, carcinoid
    • Dilation of valve ring: pulmonary hypertension; Marfan syndrome
    • Congenital: isolated or associated with tetralogy of Fallot, VSD, pulmonic stenosis
• Mid-Diastolic Murmurs
  • Mitral
    • MS
    • Carey-Coombs murmur (mid-diastolic apical murmur in acute rheumatic fever)
    • Increased flow across nonstenotic mitral valve (e.g., MR, VSD, PDA, high-output states, and complete heart block)
  • Tricuspid
    • Tricuspid stenosis
    • Increased flow across nonstenotic tricuspid valve (e.g., TR, ASD, and anomalous pulmonary venous return)
  • Left and right atrial tumors (myxoma)
  • Severe AR (Austin Flint murmur)