Continuous murmur: Difference between revisions
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{{ | {{SI}} | ||
{{CMG}}; {{AE}} {{TS}} | {{CMG}}; {{AE}} {{TS}} | ||
==Overview== | ==Overview== | ||
A continuous murmur begins in [[systole]] and continues into [[diastole]]. They are caused by blood flow from high pressure chambers into low pressure chambers. The most common causes of continuous murmurs are [[patent ductus arteriosus]], [[arteriovenous fistula]] and arterial [[stenosis]]. | |||
==Causes== | ==Causes== | ||
===Life Threatening Causes=== | ===Life Threatening Causes=== | ||
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. | Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated. | ||
*[[Abdominal aortic aneurysm]] | |||
*[[Pulmonary embolism]]<ref name="pmid975962">{{cite journal| author=ZuWallack RL, Liss JP, Lahiri B| title=Acquired continuous murmur associated with acute pulmonary thromboembolism. | journal=Chest | year= 1976 | volume= 70 | issue= 4 | pages= 557-9 | pmid=975962 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=975962 }} </ref> | |||
===Common Causes=== | ===Common Causes=== | ||
*[[Anemia]] | |||
*[[Aortic coarctation]] | |||
*[[Arteriovenous fistula]] | |||
*[[Venous hum|Cervical venous hum]] | |||
*[[Patent ductus arteriosus]] | |||
*[[Pericardial friction rub]] | |||
*[[Pregnancy]] | |||
*[[Pulmonary arteriovenous fistula]] | |||
*[[Renal artery stenosis]] | |||
*[[Valvular heart disease ]] | |||
===Causes by Organ System=== | ===Causes by Organ System=== | ||
{|style="width:80%; height:100px" border="1" | {|style="width:80%; height:100px" border="1" | ||
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular''' | |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular''' | ||
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[ | |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Abdominal aortic aneurysm]], [[anemia]], [[aortic coarctation]], [[Fistula|aortic-atrial fistulas]],<ref name="pmid16412186">{{cite journal| author=Jassal DS, Neilan TG, Hung J| title=A continuous murmur. | journal=Echocardiography | year= 2006 | volume= 23 | issue= 1 | pages= 60-1 | pmid=16412186 | doi=10.1111/j.1540-8175.2005.00112.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16412186 }} </ref> [[arteriovenous fistula]], [[arteriovenous malformation]], [[atrial septal defect]] with [[mitral stenosis]], [[carotid artery stenosis]], [[celiac artery]] stenosis, [[Venous hum|cervical venous hum]], [[coronary artery fistula ]], [[Cruveilhier-Baumgarten murmur|hepatic hum]], [[Lutembacher's syndrome]], [[mammary souffle]], [[mitral stenosis]] with [[SVC|a persistent left superior vena cava]], [[patent ductus arteriosus]], [[pericardial friction rub]], [[pulmonary atresia]] with [[ventricular septal defect]], [[renal artery stenosis]], [[Aneurysm of sinus of valsalva complications|ruptured aneurysm of sinus of valsalva]], [[takayasu arteritis]], [[total anomalous pulmonary venous drainage]], [[tricuspid atresia]], [[tricuspid regurgitation]], [[truncus arteriosus]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Dermatologic''' | | '''Dermatologic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Drug Side Effect''' | | '''Drug Side Effect''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"|No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Endocrine''' | | '''Endocrine''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Hyperthyroidism]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Gastroenterologic''' | | '''Gastroenterologic''' | ||
|bgcolor="Beige"| [[ | |bgcolor="Beige"| [[Cirrhosis]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Genetic''' | | '''Genetic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Hematologic''' | | '''Hematologic''' | ||
|bgcolor="Beige"| [[ | |bgcolor="Beige"|[[Anemia]], [[hepatic hemangioma]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Iatrogenic | | '''Iatrogenic'' | ||
|bgcolor="Beige"| [[ | |bgcolor="Beige"|[[Arteriovenous fistula]], [[cimino fistula]], [[Fistula|fistula between an internal mammary graft and the pulmonary vasculature]]<ref name="pmid15301909">{{cite journal| author=Guray U, Guray Y, Ozbakir C, Yilmaz MB, Sasmaz H, Korkmaz S| title=Fistulous connection between internal mammary graft and pulmonary vasculature after coronary artery bypass grafting: a rare cause of continuous murmur. | journal=Int J Cardiol | year= 2004 | volume= 96 | issue= 3 | pages= 489-92 | pmid=15301909 | doi=10.1016/j.ijcard.2003.05.035 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15301909 }} </ref> | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Infectious Disease''' | | '''Infectious Disease''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Nutritional/Metabolic''' | | '''Nutritional/Metabolic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Anemia]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Obstetric/Gynecologic''' | | '''Obstetric/Gynecologic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Mammary souffle]], [[pregnancy]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Oncologic''' | | '''Oncologic''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"|[[Cholangiocarcinoma]], [[hemangioma|hepatic hemangioma]], [[hepatoma]], [[metastasis|liver metastases]], [[renal cell carcinoma]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Pulmonary''' | | '''Pulmonary''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"|[[Pulmonary arteriovenous fistula]], [[pulmonary artery stenosis]], [[pulmonary atresia]] with [[ventricular septal defect]], [[pulmonary embolism]]<ref name="pmid975962">{{cite journal| author=ZuWallack RL, Liss JP, Lahiri B| title=Acquired continuous murmur associated with acute pulmonary thromboembolism. | journal=Chest | year= 1976 | volume= 70 | issue= 4 | pages= 557-9 | pmid=975962 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=975962 }} </ref> | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Renal/Electrolyte''' | | '''Renal/Electrolyte''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| [[Renal artery stenosis]], [[renal cell carcinoma]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Rheumatology/Immunology/Allergy''' | | '''Rheumatology/Immunology/Allergy''' | ||
|bgcolor="Beige"| [[ | |bgcolor="Beige"|[[Paget's disease]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Trauma''' | | '''Trauma''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"|[[Arteriovenous fistula]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
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|-bgcolor="LightSteelBlue" | |-bgcolor="LightSteelBlue" | ||
| '''Miscellaneous''' | | '''Miscellaneous''' | ||
|bgcolor="Beige"| | |bgcolor="Beige"| No underlying causes | ||
|- | |- | ||
|} | |} | ||
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*[[Anemia]] | *[[Anemia]] | ||
*[[Aortic coarctation]] | *[[Aortic coarctation]] | ||
*[[Aortic-atrial fistulas]]<ref name="pmid16412186">{{cite journal| author=Jassal DS, Neilan TG, Hung J| title=A continuous murmur. | journal=Echocardiography | year= 2006 | volume= 23 | issue= 1 | pages= 60-1 | pmid=16412186 | doi=10.1111/j.1540-8175.2005.00112.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16412186 }} </ref> | *[[Fistula|Aortic-atrial fistulas]]<ref name="pmid16412186">{{cite journal| author=Jassal DS, Neilan TG, Hung J| title=A continuous murmur. | journal=Echocardiography | year= 2006 | volume= 23 | issue= 1 | pages= 60-1 | pmid=16412186 | doi=10.1111/j.1540-8175.2005.00112.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16412186 }} </ref> | ||
*[[Arteriovenous fistula]] | *[[Arteriovenous fistula]] | ||
*[[Arteriovenous malformation]] | *[[Arteriovenous malformation]] | ||
*[[Atrial septal defect]] with [[mitral stenosis]] | *[[Atrial septal defect]] with [[mitral stenosis]] | ||
*[[Carotid artery stenosis]] | *[[Carotid artery stenosis]] | ||
*[[Celiac artery stenosis]] | *[[Celiac artery| Celiac artery stenosis]] | ||
*[[Venous hum|Cervical venous hum]] | *[[Venous hum|Cervical venous hum]] | ||
*[[Cholangiocarcinoma]]<ref name="pmid222133">{{cite journal| author=Motoki T, Hayashi T, Katoh Y, Sakamoto T, Takeda T, Murao S| title=Hepatic bruits in malignant liver tumors. | journal=Am J Gastroenterol | year= 1979 | volume= 71 | issue= 6 | pages= 582-6 | pmid=222133 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=222133 }} </ref> | *[[Cholangiocarcinoma]]<ref name="pmid222133">{{cite journal| author=Motoki T, Hayashi T, Katoh Y, Sakamoto T, Takeda T, Murao S| title=Hepatic bruits in malignant liver tumors. | journal=Am J Gastroenterol | year= 1979 | volume= 71 | issue= 6 | pages= 582-6 | pmid=222133 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=222133 }} </ref> | ||
*[[Cimino fistula]] | *[[Cimino fistula]] | ||
*[[Cirrhosis]]<ref name="pmid13230354">{{cite journal| author=MACPHERSON AI, MORTON EV| title=Continuous venous hum in a case of portal cirrhosis. | journal=Br Heart J | year= 1955 | volume= 17 | issue= 1 | pages= 105-8 | pmid=13230354 | doi= | pmc=PMC503892 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13230354 }} </ref> | *[[Cirrhosis]]<ref name="pmid13230354">{{cite journal| author=MACPHERSON AI, MORTON EV| title=Continuous venous hum in a case of portal cirrhosis. | journal=Br Heart J | year= 1955 | volume= 17 | issue= 1 | pages= 105-8 | pmid=13230354 | doi= | pmc=PMC503892 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13230354 }} </ref> | ||
*[[Coronary artery fistula]] | |||
{{col-break|width=33%}} | {{col-break|width=33%}} | ||
*[[ | *[[Fistula|Fistula between an internal mammary graft and the pulmonary vasculature]]<ref name="pmid15301909">{{cite journal| author=Guray U, Guray Y, Ozbakir C, Yilmaz MB, Sasmaz H, Korkmaz S| title=Fistulous connection between internal mammary graft and pulmonary vasculature after coronary artery bypass grafting: a rare cause of continuous murmur. | journal=Int J Cardiol | year= 2004 | volume= 96 | issue= 3 | pages= 489-92 | pmid=15301909 | doi=10.1016/j.ijcard.2003.05.035 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15301909 }} </ref> | ||
*[[Hemangioma|Hepatic hemangioma]] | |||
* | |||
*[[Cruveilhier-Baumgarten murmur|Hepatic hum]] | *[[Cruveilhier-Baumgarten murmur|Hepatic hum]] | ||
*[[Hepatoma]] | *[[Hepatoma]] | ||
*[[Hyperthyroidism]] | *[[Hyperthyroidism]] | ||
* | *[[Metastasis|Liver metastasis]]<ref name="pmid222133">{{cite journal| author=Motoki T, Hayashi T, Katoh Y, Sakamoto T, Takeda T, Murao S| title=Hepatic bruits in malignant liver tumors. | journal=Am J Gastroenterol | year= 1979 | volume= 71 | issue= 6 | pages= 582-6 | pmid=222133 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=222133 }} </ref> | ||
*[[Lutembacher's syndrome]] | *[[Lutembacher's syndrome]] | ||
*[[Mammary souffle]] | *[[Mammary souffle]] | ||
*[[Mitral stenosis]] with a persistent left | *[[Mitral stenosis]] [[SVC|with a persistent left superior vena cava]] | ||
*[[Paget's disease]] | *[[Paget's disease]] | ||
*[[Pulmonary embolism]]<ref name="pmid975962">{{cite journal| author=ZuWallack RL, Liss JP, Lahiri B| title=Acquired continuous murmur associated with acute pulmonary thromboembolism. | journal=Chest | year= 1976 | volume= 70 | issue= 4 | pages= 557-9 | pmid=975962 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=975962 }} </ref> | *[[Pulmonary embolism]]<ref name="pmid975962">{{cite journal| author=ZuWallack RL, Liss JP, Lahiri B| title=Acquired continuous murmur associated with acute pulmonary thromboembolism. | journal=Chest | year= 1976 | volume= 70 | issue= 4 | pages= 557-9 | pmid=975962 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=975962 }} </ref> | ||
*[[Patent ductus arteriosus]] | *[[Patent ductus arteriosus]] | ||
*[[Pericardial friction rub]] | |||
{{col-break|width=33%}} | |||
*[[Pregnancy]] | *[[Pregnancy]] | ||
*[[Pulmonary arteriovenous fistula]] | *[[Pulmonary arteriovenous fistula]] | ||
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*[[Renal artery stenosis]] | *[[Renal artery stenosis]] | ||
*[[Renal cell carcinoma]] | *[[Renal cell carcinoma]] | ||
*[[Ruptured aneurysm of sinus of valsalva]] | *[[Aneurysm of sinus of valsalva complications|Ruptured aneurysm of sinus of valsalva]] | ||
*[[Takayasu arteritis]] | *[[Takayasu arteritis]] | ||
*[[Total anomalous pulmonary venous drainage]] | *[[Total anomalous pulmonary venous drainage]] | ||
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*[[Tricuspid regurgitation]] | *[[Tricuspid regurgitation]] | ||
*[[Truncus arteriosus]] | *[[Truncus arteriosus]] | ||
*[[Valvular heart disease ]] | *[[Valvular heart disease ]] | ||
{{col-end}} | {{col-end}} |
Latest revision as of 22:09, 25 November 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Twinkle Singh, M.B.B.S. [2]
Overview
A continuous murmur begins in systole and continues into diastole. They are caused by blood flow from high pressure chambers into low pressure chambers. The most common causes of continuous murmurs are patent ductus arteriosus, arteriovenous fistula and arterial stenosis.
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.
Common Causes
- Anemia
- Aortic coarctation
- Arteriovenous fistula
- Cervical venous hum
- Patent ductus arteriosus
- Pericardial friction rub
- Pregnancy
- Pulmonary arteriovenous fistula
- Renal artery stenosis
- Valvular heart disease
Causes by Organ System
Causes in Alphabetical Order
References
- ↑ 1.0 1.1 1.2 ZuWallack RL, Liss JP, Lahiri B (1976). "Acquired continuous murmur associated with acute pulmonary thromboembolism". Chest. 70 (4): 557–9. PMID 975962.
- ↑ 2.0 2.1 Jassal DS, Neilan TG, Hung J (2006). "A continuous murmur". Echocardiography. 23 (1): 60–1. doi:10.1111/j.1540-8175.2005.00112.x. PMID 16412186.
- ↑ 3.0 3.1 Guray U, Guray Y, Ozbakir C, Yilmaz MB, Sasmaz H, Korkmaz S (2004). "Fistulous connection between internal mammary graft and pulmonary vasculature after coronary artery bypass grafting: a rare cause of continuous murmur". Int J Cardiol. 96 (3): 489–92. doi:10.1016/j.ijcard.2003.05.035. PMID 15301909.
- ↑ 4.0 4.1 Motoki T, Hayashi T, Katoh Y, Sakamoto T, Takeda T, Murao S (1979). "Hepatic bruits in malignant liver tumors". Am J Gastroenterol. 71 (6): 582–6. PMID 222133.
- ↑ MACPHERSON AI, MORTON EV (1955). "Continuous venous hum in a case of portal cirrhosis". Br Heart J. 17 (1): 105–8. PMC 503892. PMID 13230354.