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continuous murmur

Etiology: 1) patent ductus arteriosus 2) coarctation of the aorta (occasional) 3) AV fistula, coronary or systemic 4) aortopulmonary septal defect 5) ruptured aneurysm in the sinus of Valsalva 6) proximal coronary artery stenosis 7) anomalous left coronary artery 8) pulmonary artery branch stenosis 9) bronchial collateral circulation 10) small (restrictive) atrial septal defect with mitral stenosis 11) intercostal AV fistula 12) cervical venous hum 13) mammary souffle Clinical manifestations: - present in systole & diastole (envelops S2) Special laboratory: 1) transthoracic echocardiogram (all) [3] 2) transesophageal echocardiogram - improved imaging quality, especially for mitral valve

Specific

cervical venous hum mammary souffle

General

heart murmur

References

  1. Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 327-28
  2. Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 199
  3. Medical Knowledge Self Assessment Program (MKSAP) 14, 17, 18. American College of Physicians, Philadelphia 2006, 2015, 2018.
  4. What Is a Heart Murmur? http://www.nhlbi.nih.gov/health/dci/Diseases/heartmurmur/hmurmur_what.html

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