Gallavardin Phenomenon in Aortic Stenosis

Abstract

In 1925, Gallavardin reported that the harsh murmur of aortic valvular stenosis could change in quality and become musical at the apex.1He postulated that the high-pitched musical components of the murmur of aortic stenosis were preferentially transmitted to the apex through solid tissues, whereas the lower-pitched components were transmitted to the neck vessels via the flow of blood. Subsequently, Gallavardin's findings have been noted by others.2-5Thus, the Gallavardin phenomenon and its proposed mechanism have become well accepted. While recently studying a patient with aortic stenosis and the Gallavardin phenomenon, it occurred to us that the high-pitched musical murmur might be secondary to the development of papillary muscle dysfunction. The following evidence is presented to support this hypothesis. Patient Summary A 30-year-old man was admitted to the Tulane Cardiology Service at the Charity Hospital of Louisiana at New Orleans for evaluation and treatment of severe aortic stenosis