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What is the significance of a diastolic rumble in mitral regurgitation ?

What is the significance of a diastolic rumble in mitral regurgitation ? 

It signifies the presence of' coexistent mitral stenosis. 

In the absence of mitral stenosis it suggests that there is high diastolic transmitral flow and severe mitral regur-gitation. Inhalation of amyl nitrate increases both the duration and intensity of the diastolic murmur due to mitral stenosis whereas it decreases them if the diastolic rumble is caused solely by mitral regurgitation. Also the presence of an opening snap suggests mitral stenosis as the cause of the diastolic rumble.

What is the significance of third heart sounds in mitral regurgitation ?

What is the significance of third heart sounds in mitral regurgitation ? 

The prevalence of third heart sounds increases with the severity of mitral regur-gitation. 

However, in patients with mitral regurgitation, the third heart sound is due to rapid ventricular filling and does not necessarily reflect left ventricular systolic dysfunction or increased filling pressure. 

In this situation S3 is caused by rapid filling of the left ventricle by the large volume et blood stored in the left atrium in diastole.

When does the murmur of mitral regurgitation radiate to the neck (i.e. base of the heart) ?

When does the murmur of mitral regurgitation radiate to the neck (i.e. base of the heart) ?

Rarely, due to involvement of the posterior mitral leaflet or to ruptured chordae tendineae, the regurgitant jet strikes the left atrial wall adjacent to the aortic root and the murmur radiates to the base of the heart, and therefore may be confused with the murmur of aortic stenosis.

Postimet e fundit






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