Symptom >> Surgical >> Cardiothoracic Surgery

Narrow murmur

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction A group of mixed sounds with different frequencies, different intensities, and longer durations than heart whispers. It can be separated or continuous with the heart sound, and even completely cover the heart sound. According to the period of occurrence, systolic murmur, diastolic murmur and continuous murmur; according to the nature can be divided into jet, reflow, music; sound, thunder, hair dryer, machine sample, etc.; according to the intensity is divided into six levels; According to its clinical significance, functional murmurs and organic murmurs can be divided. Functional murmurs are quite common in healthy people, and organic murmurs have important diagnostic implications for heart disease and certain congenital cardiovascular diseases.

Cause

Cause

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.

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.

Examine

an examination

Related inspection

Heart sound map examination cardiovascular MRI examination electrocardiogram

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 murmur of 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.

Diagnosis

Differential diagnosis

Pulmonary stenosis murmur: 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, thereby forming a noise. The murmur is typical of systolic murmur, rough, strong hair is above 3/6, often accompanied by tremor and P2 weakened.

Pulmonary murmurs are classified into systolic murmurs and diastolic murmurs. Pulmonary artery murmurs generally indicate pulmonary artery malformation or pulmonary regurgitation, pulmonary regurgitation and other factors.

The heart murmur (cordiac murmur) refers to a kind of non-heart sounding noise sounds with different frequencies, different intensities and long durations other than heart sounds and additional heart sounds. It can be separated or continuous with the heart sound, or it can completely cover the heart sound. Heart murmurs can be seen in healthy people and more in patients with cardiovascular disease. Some murmurs are the main basis for the diagnosis of heart disease, such as the mid-diastolic phase with pre-systolic rumbling murmur in the apical region, which can be diagnosed as mitral stenosis. The second intercostal continuum of the left sternal border is a loud, murmur with continuous tremor, often suggesting the presence of patent ductus arteriosus, and cardiac occlusion plays an extremely important role in the diagnosis of heart disease.