WordNet
- speak softly or indistinctly; "She murmured softly to the baby in her arms"
- make complaining remarks or noises under ones breath; "she grumbles when she feels overworked" (同)mutter, grumble, croak, gnarl
- of or relating to a diastole or happening during a diastole
- making a low continuous indistinct sound; "like murmuring waves"; "susurrant voices" (同)susurrant, whispering
PrepTutorEJDIC
- (流れる水・そよぐ葉などの)『ざわるき』,かすかな音;(人の声の)『ささやき』,ぼそぼそいう声《+『of』+『名』》 / 不平の声,ぶつぶつ言うこと / 〈川・風・木の葉などが〉『ざわめく』 / 〈人が〉『ささやく』,つぶやく / 《まれ》(…について)ぶつぶつ不平を言う《+『at』(『against, about』)+『名』》 / …‘を'『ささやく』,ぼそぼそと言う,小声で言う
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2014/04/08 16:16:52」(JST)
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Auscultogram from normal and abnormal heart sounds
Diastolic heart murmurs are heart murmurs heard during diastole.[1][2][3]
Diastolic murmurs start at or after S2 and end before or at S1.
Many involve narrowing of the atrioventricular valves or regurgitation of the semilunar valves.
Contents
- 1 Types
- 2 Individual murmurs
- 2.1 Early diastolic
- 2.2 Mid-diastolic
- 2.3 Late diastolic
- 3 References
Types
- Early diastolic murmurs start at the same time as S2 with the close of the semilunar (aortic & pulmonary) valves and typically end before S1. Common causes include aortic or pulmonary regurgitation and left anterior descending artery stenosis.
- Mid-diastolic murmurs start after S2 and end before S1. They are due to turbulent flow across the atrioventricular (mitral & tricuspid) valves during the rapid filling phase from mitral or tricuspid stenosis.
- Late diastolic (presystolic) murmurs start after S2 and extend up to S1 and have a crescendo configuration. They can be associated with AV valve narrowing.[4] They include mitral stenosis, tricuspid stenosis, myxoma, and complete heart block.
Individual murmurs
Early diastolic
Time |
Condition |
Description |
Early diastolic |
Aortic regurgitation |
The murmur is low intensity, high-pitched, best heard over the left sternal border or over the right second intercostal space, especially if the patient leans forward and holds breath in full expiration. The radiation is typically toward the apex. The configuration is usually decrescendo and has a blowing character. The presence of this murmur is a good positive predictor for AR and the absence of this murmur strongly suggests the absence of AR. An Austin Flint murmur is usually associated with significant aortic regurgitation. |
Early diastolic |
Pulmonary regurgitation |
Pulmonary regurgitation is most commonly due to pulmonary hypertension (Graham-Steell murmur). It is a high-pitched and blowing murmur with a decrescendo configuration. It may increase in intensity during inspiration and best heard over left second and third intercostal spaces. The murmur usually does not extend to S1. |
Early diastolic |
Left anterior descending artery stenosis |
This murmur, also known as Dock's murmur, is similar to that of aortic regurgitation and is heard at the left second or third intercostal space. A Coronary artery bypass surgery can eliminate the murmur. |
Mid-diastolic
Time |
Condition |
Description |
Mid-diastolic |
Mitral stenosis |
This murmur has a rumbling character and is best heard with the bell of the stethoscope in the left ventricular impulse area with the patient in the lateral decubitus position. It usually starts with an opening snap. In general, the longer the duration, the more severe the mitral stenosis. However, this rule can be misleading in situations where the stenosis is so severe that the flow becomes reduced, or during high-output situations such as pregnancy where a less severe stenosis may still produce a strong murmur. In mitral stenosis, tapping apical impulse is present. |
Mid-diastolic |
Tricuspid stenosis |
Best heard over the left sternal border with rumbling character and tricuspid opening snap with wide splitting S1. May increase in intensity with inspiration (Carvallo's sign). Tricuspid stenosis often occurs in association with mitral stenosis. Isolated TS are often associated with carcinoid disease and right atrial myxoma. |
Mid-diastolic |
Atrial myxoma |
Atrial myxomas are benign tumors of the heart. Left myxomas are far more common than right myxomas and those may cause obstruction of the mitral valve producing a mid-diastolic murmur similar to that of mitral stenosis. An echocardiographic evaluation is necessary. |
Mid-diastolic |
Increased flow across the atrioventricular valve |
This can also produce a mid-diastolic murmur, such as in severe mitral regurgitation where a large regurgitant volume in the left atrium can lead to "functional mitral stenosis." |
Mid-diastolic |
Austin Flint murmur |
An apical diastolic rumbling murmur in patients with pure aortic regurgitation. This can be mistaken with the murmur in mitral stenosis and should be noted by the fact that an Austin Flint murmur does not have an opening snap that is found in mitral stenosis. |
Mid-diastolic |
Carey-Coombs murmur |
A mid-diastolic murmur over the left ventricular impulse due to mitral valvulitis from acute rheumatic fever. |
Late diastolic
Time |
Condition |
Description |
Late diastolic (presystolic) |
Complete heart block |
A short late diastolic murmur can occasionally be heard (Rytand's murmur). |
References
- ^ "diastolic murmur" at Dorland's Medical Dictionary
- ^ "Diastolic Murmurs -- Clinical Methods -- NCBI Bookshelf". Retrieved 2008-12-31.
- ^ "Techniques - Heart Sounds & Murmurs Exam - Physical Diagnosis Skills - University of Washington School of Medicine". Retrieved 2009-03-06.
- ^ "presystolic murmur" at Dorland's Medical Dictionary
Symptoms and signs: circulatory (R00–R03, 785)
|
|
Medical examination and history taking
|
|
Cardiovascular |
Heart disease
|
- Cardiovascular chest pain
- Tachycardia/Bradycardia
- Palpitation
- Cœur en sabot
- Jugular venous pressure
- Carotid bruit
|
|
Auscultation
|
- Heart sounds
- Split S2
- Third heart sound
- Fourth heart sound
- Gallop rhythm
- Heart murmur
- Systolic
- Diastolic
- Continuous
- Pericardial friction rub
- Heart click
|
|
Pulse
|
- Pulsus tardus et parvus
- Pulsus paradoxus
- doubled
- Pulsus bisferiens
- Dicrotic pulse
- Pulsus bigeminus
- Pulsus alternans
|
|
Vascular disease
|
|
|
|
Myeloid/blood |
Shock
|
- Cardiogenic
- Hypovolemic
- Distributive
|
|
Hyperaemia
|
|
|
Anemia
|
|
|
|
|
|
noco/cong/tumr, sysi/epon, injr
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proc, drug (C1A/1B/1C/1D), blte
|
|
|
anat (a:h/u/t/a/l,v:h/u/t/a/l)/phys/devp/cell/prot
|
noco/syva/cong/lyvd/tumr, sysi/epon, injr
|
proc, drug (C2s+n/3/4/5/7/8/9)
|
|
|
cell/phys (coag, heme, immu, gran), csfs
|
rbmg/mogr/tumr/hist, sysi/epon, btst
|
drug (B1/2/3+5+6), btst, trns
|
|
|
|
Eponymous medical signs for circulatory system
|
|
Heart disease |
Heart murmur |
- Systolic heart murmur: benign paediatric heart murmur (Still's murmur)
- Diastolic heart murmur: pulmonic regurgitation (Graham Steell murmur)
- aortic insufficiency (Austin Flint murmur) carey coombs murmur
- mitral regurgitation (Presystolic murmur)
|
|
Aortic insufficiency |
- Watson's water hammer pulse/Corrigan pulse
- De Musset's sign
- Duroziez's sign
- Müller's sign
- Quincke's sign
- Austin Flint murmur
- Mayne's sign
|
|
Other endocardium |
- endocarditis: Roth's spot
- Janeway lesion/Osler's node
- Bracht-Wachter bodies
|
|
Pericardium |
- cardiac tamponade/pericardial effusion: Beck's triad
- Ewart's sign
|
|
Other |
- rheumatic fever: Anitschkow cell
- Aschoff body
- angina pectoris (Levine's sign)
|
|
|
Vascular disease |
Arterial |
- aortic aneurysm (Cardarelli's sign, Oliver's sign)
- pulmonary embolism (McConnell's sign)
- radial artery sufficiency (Allen's test)
- pseudohypertension (Osler's sign)
- thrombus (Lines of Zahn)
- Adson's sign
- arteriovenous fistula (Nicoladoni sign)
|
|
Venous |
- Friedreich's sign
- Caput medusae
- Kussmaul's sign
- DVT
- Bancroft's sign
- Homans sign
- Lisker's sign
- Louvel's sign
- Lowenberg's sign
- Peabody's sign
- Pratt's sign
- Rose's sign
- Trendelenburg test
- superior vena cava syndrome (Pemberton's sign)
|
|
|
|
|
noco/cong/tumr, sysi/epon, injr
|
proc, drug (C1A/1B/1C/1D), blte
|
|
|
anat (a:h/u/t/a/l,v:h/u/t/a/l)/phys/devp/cell/prot
|
noco/syva/cong/lyvd/tumr, sysi/epon, injr
|
proc, drug (C2s+n/3/4/5/7/8/9)
|
|
|
|
UpToDate Contents
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English Journal
- Unraveling the Mystery of Pulmonary Hypertension in a Young Female.
- Haseer Koya H, Varghese D, Ananthan D, John D, George T.
- Chest.Chest.2014 Oct 1;146(4_MeetingAbstracts):892A. doi: 10.1378/chest.1968180.
- SESSION TITLE: Pulmonary Vascular Disease Student/Resident Case Report Posters IISESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Sinus of Valsalva aneurysm(SVA) is an extremely rare cardiac anomaly (dilatation of aortic wa
- PMID 25334970
- Management of Cardiac Tamponade in Severe Pulmonary Hypertension.
- Vallabhajosyula S, Kanuri S, Sundaragiri P, Alla V.
- Chest.Chest.2014 Oct 1;146(4_MeetingAbstracts):881A. doi: 10.1378/chest.1969231.
- SESSION TITLE: Pulmonary Vascular Disease Student/Resident Case Report Posters ISESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: The incidence of Pericardial effusion (PCE) in Pulmonary Artery Hypertension (PAH) is 15-65% C
- PMID 25334958
Japanese Journal
- 症例報告 紐状疣贅の塊状形態への増大に伴って楽音様拡張期雑音が消失した感染性心内膜炎の1例
- 横井 靖世,福田 信夫,福田 大和 [他]
- 日本心臓病学会誌 : Journal of cardiology. Japanese edition 7(1), 8-13, 2012-02
- NAID 40019202031
Related Links
- Diastolic heart murmurs are heart murmurs heard during diastole. Diastolic murmurs ... [edit] Types. Early diastolic murmurs start at the same time as S2 with the close of the semilunar (aortic & pulmonary) valves and typically end before S1.
Related Pictures
★リンクテーブル★
[★]
- 英
- diastolic murmur, DM
- 関
- 心雑音、拡張期性心雑音
- 拡張期に聴取される雑音
- 健常者では聴取されないので、拡張期に雑音を聴いたら病的 ⇔ 収縮期雑音として無害性雑音を聴取しても問題ない
diastolic murmurs (PHD.42)
- early decrescendo:AR・PR(left sternal border)
- mid-to-late:MS(mitral area), PS(tricuspid area)
[★]
- 関
- diastolic murmur、heart murmur
[★]
- 英
- diastolic murmur
- 関
- 拡張期雑音
[★]
- 関
- diastole