Diastolic tremor

Tremor is a small tremor felt on the palm of the hand when palpating. It is similar to breathing tremor felt in the throat of a cat, also known as cat asthma. The mechanism of tremor is the same as that of murmur. It is caused by blood flowing through a narrow caliber or in an abnormal direction to form a vortex, which causes the vibration of the valve, blood vessel wall or heart cavity wall to be transmitted to the chest wall. After the tremor is found, the location and source (valve, large blood vessel, or septal defect) should be determined first, and then the phase (systole, diastole, or continuity) in the cardiac cycle is determined. Finally, its clinical significance is analyzed. In general, tremor is seen in some congenital cardiovascular disease and stenotic valvular disease, and tremor is less common when the valve is incompletely closed, and tremor is only accessible when the atrioventricular valve is severely closed. Except for the tremor produced by the right heart (tricuspid valve and pulmonary valve), tremor is easier to reach after deep exhalation. Clinically, anyone who touches tremor can be considered as having organic disease in the heart. A loud murmur can also be heard on palpation of tremors. However, palpation is usually more sensitive to low-frequency vibrations, and auscultation is more sensitive to high-frequency vibrations. For some low-pitched diastolic murmurs (such as mitral valve stenosis), the murmur is not loud or hardly audible, and auscultation is not sensitive enough. However, tremors are still visible upon palpation and require attention.

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