Systolic ejection murmurs in the era of modern cardiology : What do we really know?

The basics of pulsatile ejection dynamics are reviewed in order to clarify the relationships among left ventricular and aortic pressures, intra-left ventricular and aortic flow velocities, and cardiovascular sound. The principles of turbulent flow are examined using the Reynolds number concept, and...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 1998-11, Vol.32 (6), p.1596-1602
Main Author: MURGO, J. P
Format: Article
Language:English
Subjects:
Aortic Valve Stenosis - physiopathology
Biological and medical sciences
Blood Pressure - physiology
Cardiology - trends
Cardiology. Vascular system
Cardiomyopathy, Hypertrophic - complications
Cardiomyopathy, Hypertrophic - physiopathology
Cardiopathies: etiologic forms (general aspects and miscellaneous)
Coronary Circulation - physiology
Heart
Heart Murmurs - etiology
Humans
Medical sciences
Reference Values
Systole
Ventricular Function, Left
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Description
Summary:The basics of pulsatile ejection dynamics are reviewed in order to clarify the relationships among left ventricular and aortic pressures, intra-left ventricular and aortic flow velocities, and cardiovascular sound. The principles of turbulent flow are examined using the Reynolds number concept, and the evidence for cause-and-effect relationships between turbulent flow and murmur generation is presented. Examples of hemodynamics and phonocardiography are given for normal subjects and are compared to patients with aortic stenosis and hypertrophic cardiomyopathy. The concepts presented are used to analyze the results of a new study suggesting increased intraventricular velocities as a new cause for systolic murmurs in adults.
ISSN:0735-1097
1558-3597
DOI:10.1016/s0735-1097(98)00425-2