Continuous murmur: Difference between revisions

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{{Continuous murmur}}
{{SI}}
{{CMG}}; {{AE}} {{TS}}
{{CMG}}; {{AE}} {{TS}}


==Overview==
==Overview==
Continuous murmurs begin in [[systole]] and continue into [[diastole]] through the second heart sound.  They are caused by blood flow from high pressure chamber to low pressure chamber.  Most common causes of continuous murmurs are [[patent ductus arteriosus]], [[arteriovenous fistula]] and arterial [[stenosis]].
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==
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{|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" | [[Abdominal aortic aneurysm]], [[anemia]], [[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> [[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 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]]
|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"
| '''Iatrogenic''
| '''Iatrogenic''
|bgcolor="Beige"|[[Arteriovenous fistula]], [[cimino fistula]], [[fistulous connection 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="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"
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| '''Obstetric/Gynecologic'''
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"|  [[Mammary souffle]], [[pregnancy ]]
|bgcolor="Beige"|  [[Mammary souffle]], [[pregnancy]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"|[[Cholangiocarcinoma]], [[hepatic hemangioma]], [[hepatoma]], [[liver metastases]], [[renal cell carcinoma]]
|bgcolor="Beige"|[[Cholangiocarcinoma]], [[hemangioma|hepatic hemangioma]], [[hepatoma]], [[metastasis|liver metastases]], [[renal cell carcinoma]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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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>
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*[[Coronary artery fistula]]
*[[Coronary artery fistula]]
{{col-break|width=33%}}
{{col-break|width=33%}}
*[[Fistulous connection 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>
*[[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>
*Hepatic [[hemangioma]]
*[[Hemangioma|Hepatic hemangioma]]
*[[Cruveilhier-Baumgarten murmur|Hepatic hum]]
*[[Cruveilhier-Baumgarten murmur|Hepatic hum]]
*[[Hepatoma]]
*[[Hepatoma]]
*[[Hyperthyroidism]]
*[[Hyperthyroidism]]
*Liver [[metastases]]<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>
*[[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 [[superior vena cava]]
*[[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>

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

Causes by Organ System

Cardiovascular Abdominal aortic aneurysm, anemia, aortic coarctation, aortic-atrial fistulas,[2] arteriovenous fistula, arteriovenous malformation, atrial septal defect with mitral stenosis, carotid artery stenosis, celiac artery stenosis, cervical venous hum, coronary artery fistula , hepatic hum, Lutembacher's syndrome, mammary souffle, mitral stenosis with a persistent left superior vena cava, patent ductus arteriosus, pericardial friction rub, pulmonary atresia with ventricular septal defect, renal artery stenosis, ruptured aneurysm of sinus of valsalva, takayasu arteritis, total anomalous pulmonary venous drainage, tricuspid atresia, tricuspid regurgitation, truncus arteriosus
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect No underlying causes
Ear Nose Throat No underlying causes
Endocrine Hyperthyroidism
Environmental No underlying causes
Gastroenterologic Cirrhosis
Genetic No underlying causes
Hematologic Anemia, hepatic hemangioma
'Iatrogenic Arteriovenous fistula, cimino fistula, fistula between an internal mammary graft and the pulmonary vasculature[3]
Infectious Disease No underlying causes
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic Anemia
Obstetric/Gynecologic Mammary souffle, pregnancy
Oncologic Cholangiocarcinoma, hepatic hemangioma, hepatoma, liver metastases, renal cell carcinoma
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Pulmonary arteriovenous fistula, pulmonary artery stenosis, pulmonary atresia with ventricular septal defect, pulmonary embolism[1]
Renal/Electrolyte Renal artery stenosis, renal cell carcinoma
Rheumatology/Immunology/Allergy Paget's disease
Sexual No underlying causes
Trauma Arteriovenous fistula
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order

References

  1. ↑ 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. ↑ 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. ↑ 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. ↑ 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.
  5. ↑ 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.
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