Diastolic murmur

Introduction Diastolic qi murmur is a type of heart murmur. Heart murmur refers to the abnormal sound produced by the vibration of the wall, valve or blood vessel caused by end-flow of blood in the heart or blood vessels in addition to heart sounds and extra heart sounds. Normal blood flow is laminar, no sound is emitted, when blood flow is accelerated, abnormal blood flow channel or blood flow diameter abnormality and blood viscosity change can make laminar flow into turbulence, or vortex to impact heart wall, large blood vessels Walls, valves, chordae, etc. vibrate and produce noise at the corresponding parts.

Cause

1, blood flow acceleration: exercise high fever, hyperthyroidism, anemia.

2, valve opening caliber or large vessel channel stenosis: mitral stenosis.

3, the valve is not closed.

4, abnormal blood flow channel: ventricular septal defect, patent ductus arteriosus.

5, foreign body or abnormal structure in the heart: intraventricular chordae, nipple muscle fracture.

6, large angiomatous expansion: aneurysm.

an examination

Related inspection

Chest B super chest MRI chest flat chest chest CT chest examination

1. palpitations: the discomfort of heart beat may be the earliest complaint, due to the obvious increase of left ventricle, increased apex beats, especially in the left lateral position or prone position. Emotional or physical activity causes tachycardia, or ventricular premature beats can make the heart palpitations more obvious. Due to the significant increase in pulse pressure, it is often felt that the body has a strong sense of arterial pulsation, especially in the head and neck.

2. Difficulty breathing: Labor dyspnea first appeared, indicating that the reserve capacity of the heart has been reduced. As the disease progresses, there may be a sitting breathing and paroxysmal nocturnal dyspnea.

3. Chest pain: angina is less common than aortic stenosis. Chest pain may be caused by excessive stretching of the ascending aorta or a significant increase in the heart during left ventricular ejection, as well as factors of myocardial ischemia. Angina pectoris can occur during activity and at rest, with a longer duration and poor response to nitroglycerin; the onset of angina at night may be due to a decrease in diastolic blood pressure due to slow heart rate during rest, which reduces coronary blood flow. For some reasons; there are also complaints of abdominal pain, speculation may be related to visceral ischemia.

4. Syncope: When changing body position quickly, dizziness or dizziness may occur, and syncope is less common.

5. Other symptoms: fatigue, activity tolerance decreased significantly. Excessive sweating, especially in the presence of nocturnal paroxysmal dyspnea or nocturnal angina. Hemoptysis and embolism are less common. In the case of advanced right heart failure, there may be hepatic congestion, tenderness, edema of the ankle, pleural effusion or ascites.

Differential diagnosis

Apical apnea

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.

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.

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.

Tricuspid valve 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.

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