Three patients developed severe pulmonary venous obstruction following Mustard operation for transposition of the great arteries. Each patient had a soft continuous murmur with distinct diastolic accentuation at the low left sternal border or xiphoid area. Simultaneous recording of intracardiac sound and pressure in one patient showed that the murmur originated at the site of obstruction in the...

We report the presence of an unusual systolic murmur associated with a traumatic left ventricular pseudoaneurysm. Echophonocardiographic studies showed the murmur to begin at the first heart sound, but end well before the second heart sound. It seems likely that the murmur is caused by the systolic flow of blood from the left ventricle into the relatively noncompliant pseudoaneurysm. The echoca...

The diagnosis of patent ductus arteriosus is difficult when the classic continuous murmur is not present. In infancy, in the presence of cardiac decompensation and when the ductus approximates the aorta in size, the continuous murmur is frequently absent. A correct diagnosis may be important, however, for a large patent ductus arteriosus can cause serious difficulty. Early surgical treatment ma...

Phonocardiography is of great importance in distinguishing coronary artery fistula from other anomalies with a continuous murmur. The presence of this murmur at the apex must be regarded as an important characteristic of a coronary artery fistu!a, especially when the maximum diastolic murmur is found at the apex. Although coronary artery fistula may be symptomless for a long time, surgical trea...

A 20-year-old asymptomatic woman was admitted to the hospital for workup of a continuous heart murmur. Five years previously, she had had a normal chest roentgenogram (Fig 1 ) before needle drainage of bilateral axillary abscess. On physical examination she had a continuous, machinery-like murmur heard predominantly on the second right intercostal space accompanied by a suprasternal systolic th...

An early diastolic murmur thought to indicate functional aortic regurgitation was heard in 7 of 74 consecutive patients with end-stage renal failure assessed for chronic intermittent haemodialysis and transplantation. In all 7 cases the murmur was transient and related to episodes of hypertension and fluid overload and disappeared on correction of these factors. In a further 2 patients aortic r...