参考

1.

http://www.gpnotebook.co.uk/simplepage.cfm?ID=1074135061&linkID=46554&cook=no&mentor=1

2.

http://en.wikipedia.org/wiki/Parasternal_heave

WordNet

utter a sound, as with obvious effort; "She heaved a deep sigh when she saw the list of things to do"
bend out of shape, as under pressure or from heat; "The highway buckled during the heat wave" (同)buckle, warp
the act of lifting something with great effort (同)heaving
throwing something heavy (with great effort); "he gave it a mighty heave"; "he was not good at heaving passes" (同)heaving
an involuntary spasm of ineffectual vomiting; "a bad case of the heaves" (同)retch
an upward movement (especially a rhythmical rising and falling); "the heaving of waves on a rough sea" (同)heaving
(geology) a horizontal dislocation
lift or elevate (同)heave up, heft, heft up
move or cause to move in a specified way, direction, or position; "The vessel hove into sight"
throw with great effort
a chronic emphysema of the horse that causes difficult expiration and heaving of the flanks (同)broken wind

PrepTutorEJDIC

《副詞[句]を伴って》〈重い物〉‘を'『力を込めて上げる』(『持ち上げる』);《話》…‘を'持ち上げて投げる / 〈息・声〉‘を'『苦しそうに出す』 / 〈胸など〉‘を'膨らませる,上下させる / 〈いかり〉‘を'巻き上げる / 《話》…‘を'投げる / 上下動をする,〈土地などが〉起伏する,〈波などが〉うねる / 〈胸が〉波打つ,あえぐ / 吐き気がする,むかつく / 《副詞[句]を伴って》〈船が〉動く,移動する / (…を)力を込めて持ち上げること(放り投げること)《+『of』+『名』》 / 《単数形で》(…が)上下動すること;膨れ上がること,(…の)隆起;(波の)うねり《+『of』+『名』》

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/04/30 20:44:14」(JST)

wiki en

[Wiki en表示]

A parasternal heave is a precordial impulse that may be felt (palpated) in patients with cardiac or respiratory disease. Precordial impulses are visible or palpable pulsations of the chest wall, which originate on the heart or the great vessels.^[1]

Technique

A parasternal impulse may be felt when the heel of the hand is rested just to the left of the sternum with the fingers lifted slightly off the chest. Normally no impulse or a slight inward impulse is felt. The heel of the hand is lifted off the chest wall with each systole. Palpation with the fingers over the pulmonary area may reveal the palpable tap of pulmonary valve closure (palpable P2) in cases of pulmonary hypertension.

Interpretation

Parasternal heave occurs in the setting of right ventricular enlargement (hypertrophy) or very rarely severe left atrial enlargement.^[2] Hypertrophy of the right side of the heart will occur when the right side of the heart chronically contracts against higher pressure. This occurs in the setting of valvular disease i.e. pulmonary valve, and in the setting of respiratory disease whereby the pressure in the pulmonary artery becomes elevated (e.g., Chronic obstructive pulmonary disease). An example of a condition where parasternal heave can be felt is Cor pulmonale. This impulse may also be felt in dilated right ventricular myopathy. The palpation of dilated myopathy differs in that the impulse tends to be vigorous and brief. This is in contrast with the sustained impulse of the hypertrophied right ventricle.^[3] A parasternal heave may also be felt in mitral stenosis.^[4]

References

^ http://www.ncbi.nlm.nih.gov/books/NBK322/
^ Clinical Examination: A Systematic Guide to Physical Diagnosis 5th Edition Nicholas Talley Simmon O' Connor
^ http://www.ncbi.nlm.nih.gov/books/NBK322/
^ Sam, Amir H.; James T.H. Teo (2010). Rapid Medicine. Wiley-Blackwell. ISBN 1-4051-8323-3.

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UpToDate Contents

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1. 前胸部拍動の検討 examination of the precordial pulsation
2. 肺性心 cor pulmonale
3. 成人における肺高血圧症の臨床的特徴および診断 clinical features and diagnosis of pulmonary hypertension in adults
4. 心雑音の聴診 auscultation of cardiac murmurs
5. 頚静脈波の検討 examination of the jugular venous pulse

English Journal

Successful balloon dilatation of both orifices in a case of double-orifice mitral valve with severe rheumatic stenosis.

Nath RK1, Soni DK2.
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.Catheter Cardiovasc Interv.2015 Sep 21. doi: 10.1002/ccd.26160. [Epub ahead of print]
A 24-year-old female patient presented to us with progressive dyspnea on exertion for last three year. She was not a known case of rheumatic heart disease. Her physical examination showed regular pulse and her blood pressure was 100/76 mm Hg. Cardiac palpation showed grade 3 parasternal heave and au
PMID 26389694

[Ventricular septal defect in an adult patient].

Gallego-Galiana J, Aguilar-Shea AL.
Semergen / Sociedad Española de Medicina Rural y Generalista.Semergen.2012 Apr;38(3):175-7.
We report the case of a 46 year old asymptomatic male whose chest X-ray showed a right aortic knob and in the physical examination he had a systolic murmur with a palpable left parasternal heave. On performing the transesophageal echocardiography and MRI a ventricular septal defect (VSD) was observe
PMID 24895722

Congenital aneurysm of the left atrium.

Rahman MM1, Pasha K, Mohsin MK, Marufuzzaman S, Habib SM, Islam MN, Debnath RC.
Mymensingh medical journal : MMJ.Mymensingh Med J.2011 Jan;20(1):155-8.
Isolated left atrial (LA) aneurysm is a rare condition, whereas LA aneurysm secondary to other causes is a fairly common condition. A case of large left atrial aneurysm presented with features of heart failure with cardiac arrhythmia and an abnormal cardiac silhouette on chest X-ray. A 14 years old
PMID 21240182

Japanese Journal

-0367-CLINICAL IMPLICATIONS OF PARASTERNAL HEAVE IN PATIENTS WITH MITRAL REGURGITATION IN ASSESSMENT OF SEVERITY OF REGURGITATION

Yokota Naji,Okada Michio,Hirata Shunkichi,Ishikawa Masamichi,Ishikawa Kyozo
Japanese circulation journal 54(7), 807, 1990-07-20
NAID 110002631853

「heave」

　　[★]

n.

(努力して)上げること、思いモノを上げる努力。持ち上がり。高まり。(凍結による)路面の凍結
(規則的な)上下動、波のうねり(of the sea)。(the ～s)むかつき、嘔吐

If the stenosis is severe with accompanying right ventricular hypertrophy, aprominent jugular venous a wave can be observed and an RV heave is palpated over the sternum.(PDH.388)