Pulmonary valve stenosis murmur

Introduction Long-term pulmonary stenosis causes a significant expansion of the main pulmonary artery and the left pulmonary artery. When the blood is ejected from the right ventricle by the right ventricle, turbulence and oscillation occur, creating a murmur. The murmur is typical of systolic murmur, rough, strong hair is above 3/6, often accompanied by tremor and P2 weakened. Pulmonary stenosis is a structural change of the heart's pulmonary valve due to various reasons. When the right ventricle contracts, the pulmonary valve cannot be fully opened, resulting in a series of pathophysiological changes in the heart.

Cause

Pulmonary stenosis is a structural change of the heart's pulmonary valve due to various reasons. When the right ventricle contracts, the pulmonary valve cannot be fully opened, resulting in a series of pathophysiological changes in the heart. Long-term pulmonary stenosis causes a significant expansion of the main pulmonary artery and the left pulmonary artery. When the blood is ejected from the right ventricle by the right ventricle, turbulence and oscillation occur, creating a murmur.

an examination

Related inspection

Pulmonary ventilation imaging pulmonary ventilation function pulmonary capillary wedge pressure

1. There are labor palpitations, shortness of breath, difficulty breathing, chest tightness, fatigue and other symptoms.

2. The second intercostal space on the left sternal border can reach the systolic tremor. When auscultation, you can hear the squeaky noise during the rough systole.

3. X-ray examination: the chest phase shows that the pulmonary vascular shadow is small, the whole lung field is abnormally clear, the total dry arc of the pulmonary artery is convex, and the right ventricle is enlarged.

4. Electrocardiogram: There may be incomplete right bundle branch block, right ventricular hypertrophy, right ventricular hypertrophy with extensive pre-cardiac t-wave inversion, and partial p-wave increase.

5. Echocardiography: The a-wave wave of the pulmonary valve echo curve is deepened (> 10 mm), and pulmonary stenosis and right ventricular hypertrophy are seen.

Differential diagnosis

Differential diagnosis of pulmonary stenosis murmur:

Systolic systolic murmur

Non-pathological apical systolic murmur rheumatic mitral valve, rheumatic mitral regurgitation, infective endocarditis rheumatic heart disease, systemic lupus erythematosus, scleroderma papillary dysfunction or lingual cord Fracture, (coronary heart disease, myocardial infarction) idiopathic ventral rupture, valve relaxation, mitral valve prolapse syndrome, Marfan syndrome, only obstructive cardiomyopathy, dilated cardiomyopathy, atrial septal defect, patent ductus arteriosus Endocardial pad defect, hyperthyroidism in pregnancy, anemia, ankylosing heart disease, heart disease, high altitude heart disease, third degree atrioventricular block cancer. Left, depleted aortic regurgitation, relative mitral regurgitation.

Diastolic murmur

Rheumatic mitral regurgitation, rheumatic mitral stenosis, infective endocarditis, rheumatoid heart disease, systemic lupus erythematosus, aortic regurgitation, Austin-Flint murmur, left atrial fluid tumor mitral valve Large neoplasms or thrombosis, constrictive pericarditis, Hurler syndrome, patent ductus arteriosus, Lutembacher syndrome, severe mitral regurgitation, severe aortic regurgitation, large ventricular septal defect, hypertensive heart Aortic coarctation, dilated cardiomyopathy, anaemia, hyperthyroidism, third degree atrioventricular block. Diastolic murmur in the apical region caused by other causes.

Tri-aortic valve systolic murmur

Rheumatic aortic valve rheumatic aortic stenosis. Aortic atherosclerosis, hypertensive heart disease, aortic stenosis syndrome, congenital bicuspid aortic valve, aortic coarctation syphilitic aortitis, aortic aneurysm, Ebstein malformation, severe aortic regurgitation, Complete atrioventricular block. Hypertrophic heart disease, anorectal systolic murmur caused by other causes of anemia, carcinoid syndrome, and carotid murmur.

Four aortic valve area diastolic murmur

Rheumatic aortic valve rheumatic aortic valve insufficiency, syphilitic aortic regurgitation, infective endarteritis, rheumatoid heart disease, systemic lupus erythematosus Marfan syndrome, aortic atherosclerosis, Hypertension-induced aortic annulus enlargement of aortic sinus aneurysm rupture, high ventricular septal defect caused by aortic valve prolapse, and other causes of aortic regurgitation.

The third and fourth intercostal systolic murmurs on the left sternal border

Ventricular septal defect in infants with non-pathologic systolic murmur, pulmonary stenosis or funnel stenosis, mitral regurgitation, aortic stenosis, aortic coarctation, atrial septal defect obstructive primary cardiomyopathy, tricuspid regurgitation Incomplete, patent ductus arteriosus, right ventricle, right atrium.

Six pulmonary systolic murmur

Non-pathological pulmonary systolic murmur rheumatic pulmonary valve disease, rheumatic pulmonary stenosis, infective endometritis, congenital pulmonary stenosis, pulmonary artery and branch stenosis Fallot tetralogy, Lutembacner syndrome, idiopathic pulmonary artery Dilated primary pulmonary hypertension, secondary pulmonary hypertension (Eisemmenger syndrome), rheumatic mitral stenosis chronic pulmonary heart disease, high altitude heart disease, atrial septal defect of straight back syndrome, arterial catheter Closed pulmonary venous malformation drainage, hyperthyroidism in pregnancy, anemia, ankylosing heart disease, carotid murmur.

Seven-pulmonary valve area diastolic murmur

Rheumatic pulmonary arteritis rheumatic pulmonary valve insufficiency, infective endocarditis, relative pulmonary valve regurgitation after surgery, pulmonary stenosis caused by Granam-stell murmur, primary pulmonary hypertension (rheumatic mitral stenosis, congenital Sexual heart disease left-right shunt) congenital pulmonary aneurysm, anemia heart disease, hyperthyroid heart disease carcinoid syndrome.

Eight-three cusp systolic murmur

Rheumatic tricuspid valve rheumatic tricuspid regurgitation. Infective endocarditis, papillary muscle dysfunction valve relaxation. Electrical high radiation injury, Ebstein malformation pulmonary heart disease, rheumatic heart disease mitral valve disease and pulmonary hypertension caused by right ventricular enlargement, congenital heart disease, a large number of left-right shunt (atrial septal defect pulmonary vein malformation drainage), primary Pulmonary hypertension.

Jiu3 cusp area diastolic murmur

Rheumatic tricuspid valve rheumatic tricuspid stenosis, mold infection. Endometritis congenital tricuspid stenosis, right atrial stenosis, mitral stenosis caused by right ventricular enlargement tricuspid regurgitation massive reflux, atrial septal defect massive left ten right shunt, anemia hyperthyroidism hyperthyroidism Sexual heart disease, carcinoid syndrome.

Continuous murmur at the bottom of ten hearts

Intravenous camping of the patent ductus arteriosus, the main pulmonary artery septal defect. Pulmonary arteriovenous and thin sinus aneurysms broke the right ventricle (atrial) congenital coronary arteriovenous thin, complete pulmonary venous malformation drainage tricuspid atresia, thoracic internal anastomosis after ventricular septal defect with aortic regurgitation, two The cusp regurgitation combined with aortic regurgitation, aortic regurgitation and stenosis.

Eleven other parts of the noise

1 head auscultation: benign head murmur eyeball murmur.

2 neck auscultation: jugular vein camp sound, subclavian artery murmur. Thyroid murmurs of the supraclavicular artery.

3 chest and back murmur: pleural adhesion murmur, breast murmur.

4 Abdominal vascular murmur: hepatic arterial murmur, hepatic vein murmur, murmur caused by renal artery stenosis, murmur from abdominal aorta and its branches, murmur from the abdominal aorta and its branches, ridge ridge Vascular noise.

5 limb auscultation: arteriovenous thin, aneurysm hemangioma, aortic valve insufficiency.

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