Diastolic Murmurs

Posted by e-Medical PPT Wednesday, December 11, 2013
Diastolic Murmurs
Always signify an abnormal cvs - structurally or functionally
Not graded by intensity but by their length
Thrill additionally mentioned

Classification
A) Those arising at the AV valves
1.Mid diastolic
2.Presystolic
3.Combined
B) Those arising at semilunar valves
1.Early diastolic
2.Mid diastolic sounding early diastolic

Diastolic murmurs at AV valves
Mechanism and Causes of Diastolic Murmurs at Apex
A- Narrowing of mitral valve or left ventricular inflow
1.Mitral stenosis
2.Left atrial myxoma
3.Cor-triatrium
4.Constriction of AV groove as in constrictive pericarditis
5.Hypertrophic cardiomyopathy (narrow inflow cavity

B.Increased flow across AV valve
1.Left to right shunts (post tricuspid shunts) (VSD,Ductus,systemic artero venous fistula,RSOV in to right ventricle,aotopulmonary window/fistula, Truncus Arteriosus)
2.Mitral Regurgitation (severe)
3.Hyperkinetics circulatory states(anemia,thyrotoxicosis,pregnancy)
4.Chronic complete heart block

C. Mechanisms that interfere with mitral valve opening
Austin flint murmur with severe aortic regurgitation

D.Ventricular aneurysm with a narrow neck

E.Murmurs arising some where else but heard at apex
1.Aortic regurgitation
2.Tricuspid stenosis
3.Tricuspid flow murmur of ASD
4.Ebstien’s anomaly
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