Heart murmur pathophysiology: Difference between revisions
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|[[aortic stenosis]] | |[[aortic stenosis]] | ||
| | |Aortic stenosis in the progressive narrowing of the aortic valve.<ref name="pmid27866029">{{cite journal| author=Galli D, Manuguerra R, Monaco R, Manotti L, Goldoni M, Becchi G et al.| title=Understanding the structural features of symptomatic calcific aortic valve stenosis: A broad-spectrum clinicopathologic study in 236 consecutive surgical cases. | journal=Int J Cardiol | year= 2016 | volume= 228 | issue= | pages= 364-374 | pmid=27866029 | doi=10.1016/j.ijcard.2016.11.180 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27866029 }} </ref> | ||
*The decrease in aortic valve area does not cause a change in the antegrade velocity unless the area is decreased by at least half. [[Aortic stenosis]] causes an impedance to the antegrade blood flow not only at the level of the aortic valve itself but also at the [[Subvalvular aortic stenosis|subvalvular]] ([[Subvalvular aortic stenosis|below the aortic valve]]) or [[Supravalvular aortic stenosis|supravalvular]] ([[Supravalvular aortic stenosis|above the aortic valve]]) levels. As a result, chronic pressure overload develops in the left ventricle. As a result, chronic pressure overload develops in the [[left ventricle]].<ref name="pmid27810479">{{cite journal| author=Joseph J, Naqvi SY, Giri J, Goldberg S| title=Aortic stenosis: pathophysiology, diagnosis and therapy. | journal=Am J Med | year= 2016 | volume= | issue= | pages= | pmid=27810479 | doi=10.1016/j.amjmed.2016.10.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27810479 }} </ref> | |||
*Slow compensatory mechanisms occur in the heart to adapt to the pressure changes caused by aortic stenosis. The most prominent adaptive mechanism is ventricular hypertrophy which leads early on to diastolic dysfunction and later on to systolic dysfunction.<ref name="pmid25140960">{{cite journal| author=Otto CM, Prendergast B| title=Aortic-valve stenosis--from patients at risk to severe valve obstruction. | journal=N Engl J Med | year= 2014 | volume= 371 | issue= 8 | pages= 744-56 | pmid=25140960 | doi=10.1056/NEJMra1313875 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25140960 }} </ref><ref name="pmid23062541">{{cite journal| author=Dweck MR, Boon NA, Newby DE| title=Calcific aortic stenosis: a disease of the valve and the myocardium. | journal=J Am Coll Cardiol | year= 2012 | volume= 60 | issue= 19 | pages= 1854-63 | pmid=23062541 | doi=10.1016/j.jacc.2012.02.093 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23062541 }} </ref> | |||
Shown below is an image summarizing the pathophysiology of aortic stenosis:<ref name="pmid23062541">{{cite journal| author=Dweck MR, Boon NA, Newby DE| title=Calcific aortic stenosis: a disease of the valve and the myocardium. | journal=J Am Coll Cardiol | year= 2012 | volume= 60 | issue= 19 | pages= 1854-63 | pmid=23062541 | doi=10.1016/j.jacc.2012.02.093 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23062541 }} </ref> | |||
[[ Image:Pathophysiology_of_aortic_stenosis.png|center|500px|Pathophysiology of aortic stenosis]] | |||
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|[[aortic regurgitation]] | |[[aortic regurgitation]] | ||
Revision as of 16:27, 28 January 2021
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Heart murmur Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Heart murmur pathophysiology On the Web |
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American Roentgen Ray Society Images of Heart murmur pathophysiology |
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Risk calculators and risk factors for Heart murmur pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Nuha Al-Howthi, MD[2]
Overview
Turbulent flow is responsible for most murmurs. Turbulent flow occurs when the velocity of blood flow becomes critically high because of a high volume of flow, the flow goes through an irregular or narrow area, the flow empties into a dilated vessel or chamber, or if the flow goes backward through an incompetent valve, septal defect, or patent ductus arteriosus. Frequently, a combination of these factors is operative. The sounds most commonly originate from the abnormal movement of blood across valves and between cardiac chambers. When this occurs, turbulence results, which produces vibrations in the chambers of the heart or outflow vessels that are detected as Murmurs.
summery of pathophysiology
| pathophysiology | |
|---|---|
| aortic stenosis | Aortic stenosis in the progressive narrowing of the aortic valve.[1]
Shown below is an image summarizing the pathophysiology of aortic stenosis:[4]  |
| aortic regurgitation | |
| mitral stenosis | |
| mitral regurgitation |
References
- ↑ Galli D, Manuguerra R, Monaco R, Manotti L, Goldoni M, Becchi G; et al. (2016). "Understanding the structural features of symptomatic calcific aortic valve stenosis: A broad-spectrum clinicopathologic study in 236 consecutive surgical cases". Int J Cardiol. 228: 364–374. doi:10.1016/j.ijcard.2016.11.180. PMID 27866029.
- ↑ Joseph J, Naqvi SY, Giri J, Goldberg S (2016). "Aortic stenosis: pathophysiology, diagnosis and therapy". Am J Med. doi:10.1016/j.amjmed.2016.10.005. PMID 27810479.
- ↑ Otto CM, Prendergast B (2014). "Aortic-valve stenosis--from patients at risk to severe valve obstruction". N Engl J Med. 371 (8): 744–56. doi:10.1056/NEJMra1313875. PMID 25140960.
- ↑ 4.0 4.1 Dweck MR, Boon NA, Newby DE (2012). "Calcific aortic stenosis: a disease of the valve and the myocardium". J Am Coll Cardiol. 60 (19): 1854–63. doi:10.1016/j.jacc.2012.02.093. PMID 23062541.