Thursday, January 25, 2018

'Named Murmurs' : Eponyms and Cardiac Auscultation

Hi everyone !
So I'm posting after ages now , since final exams just got done.
Hopefully I'll be a doctor soon (fingers crossed).

This post is about few important named auscultation findings in Cardiology. It'll provide a list of things at the same place, hopefully you find it helpful 😃

So here we go : 

1. Graham Steele Murmur

What is it : Early to Mid Diastolic Murmur at Pulmonary area 
Which condition(s) : Pulmonary Regurgitation
Key features : can be seen in Right sided overload states eg. Right ventricular failure , Mitral stenosis (MS).
( Remember Mnemonic : General Secretary or Public Relations : GS PR, trust me I've used this about Everytime I've been asked this Q)

2.  Carvallo Sign  

What is it : increase in intensity of a systolic murmur bear Apex on inspiration. 
Which condition(s) : Tricuspid Regurgitation (TR)
Key features : So the murmur of TR is a systolic one. This is heard very close to the Apex and at times may be confused for the Systolic murmur of Mitral Regurgitation.
Since the murmur of TR is a right sided murmur it increases in intensity on inspiration (as venous return increases to the right side on inspring ) , while the murmur of MR may reduce / even disappear on inspiration.

3. Austin Flint Murmur

What is it : Mid Diastolic Murmur at Mitral area 
Which condition(s) : Aortic Regurgitation (AR)
Key features : It is a functional murmur seen in AR. When the blood regurgitates from the aorta to the Left Ventricle , a jet may strike at the mitral valve leaflet - narrowing its lumen producing a functional mitral stenosis , presenting with a Mid Diastolic murmur.

4. Carey Coombs Murmur

What is it : Mid Diastolic Murmur at Mitral area 
Which condition(s) : Mitral Valvulitis ( Rheumatic )
Key features : It's different from MS murmur : No Opening snap , no radiation , no Pre systolic accentuation.

5. Gallavardin phenomenon

What is it : Systolic Murmur heard at the Apex
Which condition(s) : Aortic Stenosis
Key features : functional murmur heard at Apex in AS - example of conduction of murmur. 
( So I always would confuse Gallavardin and Carvallo.
Here's a Mnemonic : Gal's AS is on fire. )

6. Still's murmur
What is it : Systolic murmur ( without thrill)
Which condition(s) : Random : in Children
Key features : Musical murmur ( innocent ) seen in kids , absolutely harmless.

7. Hemic Murmur

What is it : Systolic Murmur ( Without thrill)
Which condition(s) : Severe Anemia
Key features : Functional murmur.

8. Gibson Murmur

What is it : Continuous murmur at upper left sternal border
Which condition(s) : Patent Ductus Arteriosus
Key features : said to have a 'Machinery' character.

Hope you find this helpful !
Happy studying !
Stay Awesome. :)

~ A.P.Burkholderia.

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