The assessment of mitral stenosis by phonocardiography.
نویسنده
چکیده
Clinical assessment of the severity of mitral stenosis sometimes presents difficulties. The symptoms may be obscured by superadded effort syndrome or by limitation of activity imposed by the patient's doctor. The physical signs may reveal the presence of pulmonary hypertension or heart failure, but in their absence there may be little indication as to the size of the mitral orifice. The intensity of the diastolic murmur is of little value since the stenosis may be severe when the murmur is slight or even absent. The degree of pulmonary hypertension measured at cardiac catheterization and the degree of right ventricular hypertrophy on the electrocardiogram are not necessarily indications of the severity of mitral stenosis. When all the evidence is considered the assessment is reasonably accurate, but there is obvious room for more direct evidence as to the degree of stenosis. The crucial information required is the pressure gradient across the mitral orifice or the rapidity of filling of the left ventricle. Such information is not necessarily an indication of the size of the mitral orifice for the ability of the left ventricle to fill in diastole must be determined in part by the involvement of the chordx tendinew, by the location and mobility of the mitral orifice, and by myocardial factors. The present study provides evidence that the pressure gradient across the mitral valve and the rapidity of filling of the left ventricle can be estimated by a phonocardiographic technique.
منابع مشابه
[Mitral stenosis].
Phonocardiography is-often more valuable than electrocardiography in timing mechanical events in the cardiac cycle. This study shows that the opening and closing of the mitral valve are related to the length of the previous heart cycle as demonstrated by the variations occuring in aluricular fibrillation. These variations in valve action are controlled by the pressure gradient between left auri...
متن کامل[Mitral stenosis].
Phonocardiography is-often more valuable than electrocardiography in timing mechanical events in the cardiac cycle. This study shows that the opening and closing of the mitral valve are related to the length of the previous heart cycle as demonstrated by the variations occuring in aluricular fibrillation. These variations in valve action are controlled by the pressure gradient between left auri...
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The diagnosis of left ventricular obstructive cardiomyopathy can be made in most instances by simple clinical examination, as practised by Paul Wood as early as 1960 (personal communication). Occasionally, there is difficulty in differentiating other causes of a systolic murmur associated with left ventricular disease. We have, therefore, assessed the diagnostic value of palpation of the caroti...
متن کاملPhono-Echocardiographic Observations
A 72-year-old man with calcific aortic stenosis and complete heart block was noted to have an intermittent diastolic murmur. Using combined echocardiography and phonocardiography, it was demonstrated that the murmur occurred while the mitral valve was closing. This suggested that antegrade flow across a closing mitral orifice is of etiologic importance in the production of the murmur. Atrial so...
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ورودعنوان ژورنال:
- British heart journal
دوره 16 3 شماره
صفحات -
تاریخ انتشار 1954