The basics of pulsatile ejection dynamics are reviewed in order to clarify the relationships among left ventricular and aortic pressures, intra-left ventricular and aortic flow velocities, and cardiovascular sound. The principles of turbulent flow are examined using the Reynolds number concept, and the evidence for cause-and-effect relationships between turbulent flow and murmur generation is p...

Physical examination on that date revealed weight of 130 kg; height 1.72 m; BMI = 43.9 kg/m2, tachypnea 36 breaths per minute, heart rate 80 bpm, blood pressure 100 x 90 mmHg. There were crackles in both lung bases; heart sounds were arrhythmic and systolic murmurs ++/6+ in the mitral area; the abdomen was distended, visceromegalies were not palpated and there was edema ++++/4+ in the lower lim...

A woman, aged 60 years, was admitted to the Royal Free Hospital with a history of severe diarrhoea and vomiting, with blood in the stools for one week. For two years she had been in poor health with episodes of giddiness, blurred vision, loss of consciousness, and numerous falls; six months previously she had been admitted to another hospital with "pyrexia of unknown origin". Relevant signs in ...

Marked changes in the auscultatory pattern with posture have been noted in patients with mid-systolic clicks and/or late systolic murmurs (MSC-LSM). MSC tend to move earlier in systole and LSM become longer and often louder when patients assume upright posture. Systolic prolapse of the mitral leaflets with mild regurgitation account for MSC-LSM; earlier and greater prolapse with more and prolon...

Marked changes in the auscultatory pattern with posture have been noted in patients with mid-systolic clicks and/or late systolic murmurs (MSC-LSM). MSC tend to move earlier in systole and LSM become longer and often louder when patients assume upright posture. Systolic prolapse of the mitral leaflets with mild regurgitation account for MSC-LSM; earlier and greater prolapse with more and prolon...

Auscultation has long been an important part of the evaluation of patients with known and suspected cardiac disease. The subsequent development of phonocardiography provided an analogue visual display that permitted a more detailed analysis of the timing and acoustical characteristics of heart sounds, murmurs, clicks and rubs. In addition, the measurement of systolic time intervals enabled a va...

BACKGROUND Almost half of the world's population uses coal and biomass fuels for domestic energy. Limited evidence suggests that exposure to air pollutants from indoor biomass combustion may be associated with elevated blood pressure (BP). OBJECTIVE Our aim was to assess the relationship between air pollution exposure from indoor biomass combustion and BP in women in rural China. METHODS We...

This review article outlines the significance and defines the skills important for the diagnosis and recognition of common innocent cardiac murmurs in childhood. The origin of heart sounds and murmurs is reviewed, and an approach to pediatric murmur evaluation is presented. The seven innocent murmurs of childhood and adolescence are reviewed in detail. Further diagnostic evaluation and referral...