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Mitral regurgitation grade 1 2 3 42/3/2024 LVEIO can also be useful for predicting prognosis in primary MR. Using appropriate thresholds, LVEIO is a simple and useful method to diagnose severe MR regardless of etiology. Multivariate analysis revealed that LVEIO was an independent predictor for all-cause death only in primary MR. This was found only in primary MR when separate analyses were performed according to etiology. Kaplan-Meier survival analysis revealed high mortality in the group with LVEIO ≥5.4 (P=0.009, hazard ratio 1.833). An optimal LVEIO threshold of 5.4 was determined to distinguish moderate to severe or severe MR from non-severe MR (sensitivity 84%, specificity 91%). MR was classified into 4 groups: Grade 0/1, no, trivial, or mild MR Grade 2, moderate MR Grade 3, moderate to severe MR and Grade 4, severe MR. The records of 18,692 consecutive patients who underwent echocardiography were reviewed. This study determined the optimal LVEIO threshold to assess severe MR with different etiologies and assessed its prognostic value. Abnormal and collapsing arterial pulsesĪ.Recently, the left ventricular early inflow-outflow index (LVEIO), calculated by dividing mitral E-wave velocity by the left ventricular outflow velocity time integral, has been proposed as a simple method for evaluating mitral regurgitation (MR).Better heard after exercise.īack to top Aortic regurgitation (aortic insufficiency)ĭefective closure of the aortic valve with blood return from the aorta to the LV during diastole Chronic aortic regurgitation Mitral stenosisīest heard as the patient is rolled onto left side with stethoscope bell at apex. Sometimes best heard if the patient is made to site up, lean forward and breathe out fully while the stethoscope at the left side of the lower part of the sternum. Increases with inspiration Aortic insufficiency Rumbling murmur, increases with inspirationīack to top What happens during special maneuvers/positioning? Pulmonary regurgitation Low-pitched, rumbling murmur heard throughout diastole: a whispered letter "r".Best heard if the patient is rolled onto left side with stethoscope bell at apex. High pitched, often faint, puffing, blowing quality Pulmonic regurgitationĬan be high-pitched or low-pitched, often faint, blowing decrescendo. Usually caused by blood flow through narrowed mitral or tricuspid valve related to abrupt deceleration of valve leaflets.įound in 60% of moderate to severe AI, related to strong regurgitant flowĪustin Flint Murmur of aortic insufficiencyīack to top Where it is best heard and where it radiates to Location of Maximal Intensityīack to top What it sounds like Aortic insufficiency Usually due to incompetence of aortic or pulmonary valve.Īortic insufficiency pulmonic regurgitationĭescribed as like a whispered letter "r".īegins after opening snap (50-100 msec after A2) Peaks at beginning of diastole when aortic or pulmonary pressure is highest and rapidly becomes quieter (decrescendo) as pressure falls. Where it is best heard and where it radiates toīack to top Where murmurs occur in diastole Diastolic murmurs are classified as:īack to top Early diastolic murmur Timing:.] Techniques: Heart Sounds & Murmurs Murmurs (general) | Systolic | Diastolicīack to top Causes Due to structural cardiac abnormalityĭue to structural cardiac abnormality and increased flow Accuracy in Diagnosis of Diastolic Murmurs.Accuracy in Diagnosis of Systolic Murmurs.
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