- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- American physician Austin Flint first described his namesake murmur in 1862. In his own poetic words: "The murmur is oftener rough than soft. The roughness is often peculiar. It is a blubbering so...
American physician Austin Flint first described his namesake murmur in 1862. In his own poetic words: "The murmur is oftener rough than soft. The roughness is often peculiar. It is a blubbering sound, resembling that produced by throwing the lips or the tongue into vibration with the breath of respiration." The murmur is best described in modern terms as a low-pitched mid to late diastolic rumble heard best at the apex of the heart and is associated with severe aortic regurgitation.
- Left ventricle pseudoaneurysm: Diagnosis by a new murmur. [Journal Article]
- JCJ Cardiol Cases 2018; 18(1):20-24
- Incomplete rupture of the ventricle free wall can occur after myocardial infarction. This occurs when an organized thrombus and the pericardium seal the ventricular perforation. This can progress to ...
Incomplete rupture of the ventricle free wall can occur after myocardial infarction. This occurs when an organized thrombus and the pericardium seal the ventricular perforation. This can progress to the formation of a left ventricle pseudoaneurysm (LVPA). A 70-year-old male with an antero-septal ST-elevation myocardial infarction (STEMI) underwent an emergent left heart catheterization which revealed severe three-vessel disease with occluded grafts, non-amenable to re-vascularization, and an apical thrombus. As he was high-risk for repeat coronary artery bypass graft, he was medically managed. Transthoracic echocardiogram (TTE) showed a normal left ventricle ejection fraction (LVEF), apical anterior and inferior wall akinesis, moderate sized apical thrombus, and pericardial thickening. On hospital day 7, examination revealed a new 3/6 to-and-fro murmur that was loudest at the apex. The patient was asymptomatic with normal vital signs. A repeat TTE revealed an apical wall rupture with flow into the pericardial cavity and absence of the apical thrombus. A LVPA was diagnosed and the patient was immediately referred for surgical repair. This case illustrates the potential for developing LVPA in STEMI patients and the importance of physical examination. If identified early a potential emergent situation in a previously asymptomatic patient can be averted, thereby preventing fatal consequences. <Learning objective: With the growing use of diagnostic testing the importance of physical examination is being lost. However, with an astute cardiac examination, potential complications such as a left ventricular pseudoaneurysm can be identified and promptly managed. In addition, a ventricular pseudoaneurysm must be considered in the differential as a rare complication in post ST-elevation myocardial infarction patients with a new murmur.>.
- Murmurs of Politics and Economics. [Journal Article]
- NEJMN Engl J Med 2018 Sep 27; 379(13):1202-1203
- Real-World Evaluation of the Eko Electronic Teleauscultation System. [Journal Article]
- PCPediatr Cardiol 2018 Aug 31
- Heart murmur evaluation is the most common cause of referral to cardiology, and auscultation of heart sounds with a stethoscope remains a key component of the initial cardiovascular exam. Adoption of...
Heart murmur evaluation is the most common cause of referral to cardiology, and auscultation of heart sounds with a stethoscope remains a key component of the initial cardiovascular exam. Adoption of telecardiology has been limited by challenges in teleauscultation. We set out to compare in-person auscultatory findings with heart sounds recorded by the Core stethoscope (Eko, Berkeley, CA) in patients with normal heart sounds, innocent heart murmurs, and a variety of pathologic findings. Our study demonstrates that Eko recordings had a high percent of agreement with in-person auscultation findings and echocardiogram findings, with moderate inter-rater reliability. It was useful in identifying patients with pathologic murmurs who would benefit from further assessment. It was able to discern major types of pathological murmurs. Certain qualitative differences in the recorded sounds as compared to in-person auscultation were identified by the reading cardiologists. They were able to acclimate to these subtle differences. The system was felt to be easy to use, and most cardiologists in the study would consider using it in clinical settings. The Eko Core system may be a useful screening tool for murmur evaluation.
- Effect of Psychoacoustic Learning on Cardiac Auscultation Proficiency in Nurse Practitioner Students. [Journal Article]
- NENurse Educ 2018 Aug 21
- CONCLUSIONS: Psychoacoustic learning may improve cardiac assessment. Further research is recommended with prelicensure nursing and NP students.
- Anomalous Origin of the Right Coronary Artery from the Pulmonary Artery in a Morbidly Obese Patient Presenting with Chest Pain. [Case Reports]
- AJAm J Case Rep 2018 Aug 22; 19:992-997
- CONCLUSIONS: By reporting this case, we shed some light on a rare congenital anomaly involving the coronary arteries. Variable presentations have been described for ARCAPA, however, many patients remain asymptomatic. Diagnosis can be confirmed by coronary angiography. Surgical correction is the definitive treatment.
- A 'fluttering' diastolic murmur. [Journal Article]
- EHEur Heart J Cardiovasc Imaging 2018 Nov 01; 19(11):1252
- Heart Murmurs. [Editorial]
- TCThorac Cardiovasc Surg 2018; 66(5):359
- An automatic segmentation method for heart sounds. [Journal Article]
- BEBiomed Eng Online 2018 Aug 06; 17(1):106
- CONCLUSIONS: The proposed method shows reliable performance on the segmentation of heart sounds. Compared with previous works, this method can be applied to not only normal heart sounds, but also the sounds with S3, S4 and murmurs, thus greatly increasing the applied range.
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- Simple risk model and score for predicting of incident atrial fibrillation in Japanese. [Journal Article]
- JCJ Cardiol 2018 Jul 28
- CONCLUSIONS: We developed 7-year risk scores for incident AF using usually available clinical factors including ECGs in primary care. These risk scores could identify individuals with high risk of incident AF at health check-up and outpatient clinics.