Musical Murmur Research Articles

Surgical Treatment of Traumatic Rupture of the Normal Aortic Valve

The histories of 2 patients who had successful repair of traumatic injury to the aortic valve are reported, and the literature is reviewed. Various types of injury cause this lesion, but violent compression of the chest with high intrathoracic pressure appears to be a common feature. Valvular injuries include avulsion of commissural attachments and tears of the leaflets. Patients present with chest pain and severe congestive heart failure, and an unusually musical murmur of aortic insufficiency is sometimes heard. Attempts at valvuloplasty have not been uniformly successful, and prosthetic valve replacement is recommended.

Newly Developed Apical Systolic Musical Murmurs during the Left Heart Catheterization

In three cases, one with angina pectoris, two with mitral stenosis, we have had an opportunity of observing the systolic musical murmurs which were newly developed during the left heart catheterization. The possible genesises of this musical murmurs were discussed in this paper.

Complex shape and variability of the diastolic murmur of aortic regurgitation

The shape of the diastolic murmur of aortic regurgitation was studied in 5 patients with musical murmurs. Instead of the traditionally postulated, simple decrescendo type, which may be preceded by a short crescendo phase, the diastolic murmur often presents a characteristically complex form. The early diastolic peak may be followed by several elements of waxing and waning intensity. Various hemodynamic factors are suggested as possible causes of these features: (1) compression chamber action; (2) effect of tidal waves; and (3) impact of contraction of the atria upon the root of the aorta. Asynchronous contraction of the atria may bring about a sand-glass-shaped presystolic element of the diastolic murmur.

High speed phonocardiography and the study of musical cardiac murmurs.

High speed phonocardiography (Caniggia, Bertelli, Lodone) was employed to analyse objectively and in detail the vibrations of heart sounds and murmurs.In this article the following murmurs were studied: 3 musical diastolic murmurs of aortic insufficiency; 5 musical mitral systolic murmurs of mitral insufficiency ; 1 musical mitral systolic murmur in aortic insufficiency ; 1 musical telesystolic murmur auscultated at a certain distance from the thorax.The main characteristic of musical murmurs is the perfectly sinusoidal shape of the vibrations which compose them.The frequency of musical aortic diastolic murmurs is about 300 c.p.s. ; the frequency of musical mitral systolic murmurs is about 150 c.p.s.

High speed phonocardiography: An Approach to the frequency analysis of the vibrations originating in the heart

High speed phonocardiography makes it possible to analyze objectively and in detail the vibrations of heart sounds and murmurs. The apparatus for high speed phonocardiography includes a cathode ray oscilloscope with five independent electronic guns and a sweep speed which can range from 2.5 cm. per second to 15 M. per second. This phonocardiographic equipment is provided with a frequency selector of the “pass-band” type which permits the simultaneous recording at high speed of the same sound analyzed at various frequencies (harmonic analysis). Heart murmurs are composed of vibrations which are irregular in shape and frequency. Only the musical murmurs are composed of vibrations of similar amplitude, following a pure sine wave. With the above technic, the main frequencies were found in the range 100 to 150 c.p.s. for mitral murmurs, in the range 150 to 250 c.p.s. for the murmur of aortic insufficiency. The highest-pitched murmurs are “musical” (300 to 350 c.p.s.). High speed harmonic analysis clearly records harmonics when they really exist. The second harmonic is often recorded and its intensity is about 1/10 of the basic vibrations. The upper harmonics are negligible with average amplification and can only be recorded with greatly increased amplification.

Bacterial Aortic Regurgitation with Musical and Associated Rumbling Diastolic Murmurs

ALTHOUGH a musical diastolic murmur in aortic regurgitation is relatively uncommon, it has such a characteristic that one can hardly forget if he hears it once. Many authors have already reported this type of murmur and in many times its genesis was proved to be luetic in origin. Rheumatic and bacterial etiology appeared to be rare in this case. Moreover, the latter case accompanied by an apical rumbling murmur due to relative mitral narrowing may be extremely uncommon, and no such report has been appeared as yet in the literature.This report illustrates an instance with a diastolic musical murmur associated with an apical rumbling murmur in a patient with aortic regurgitation due to bacterial origin.

Evaluation of the Spectral Phonocardiographic Analysis

Heart sounds can be divided into three classes: short duration pulses (first and second heart sounds); broadband long duration noise (murmur); and long duration sounds having distinct harmonic pattern (musical murmurs). The characteristics of the analysis of these classes are illustrated, and the timing, duration, and filtering artifacts are discussed. A comparison between phase and amplitude filtering is given. Application of this research instrument to clinical size and cost is considered.

Rupture of aortic valve cusp attachment due to cystic medionecrosis of the aorta: a case report with necropsy findings.

Case Reports1 November 1955RUPTURE OF AORTIC VALVE CUSP ATTACHMENT DUE TO CYSTIC MEDIONECROSIS OF THE AORTA: A CASE REPORT WITH NECROPSY FINDINGSFRANK B. HAYS, M.D., WILLARD H. BOGGAN, M.D.FRANK B. HAYS, M.D.Search for more papers by this author, WILLARD H. BOGGAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-43-5-1107 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptRupture of the aortic valve is an infrequently reported condition despite the variety of causes.1, 2, 3, 4, 5, 6, 7, 8In the majority of instances the etiology is valve damage as a result of syphilis, bacterial endocarditis or arteriosclerosis, unless there is a history of specific external trauma. A few reports1, 2, 3, 4are found in which rupture of the valve occurred spontaneously or after varying degrees of physical exertion. In the case reported below, rupture of the commissural attachment of the posterior and right anterior cusps of the aortic valve was found to be due to...Bibliography1. Howard CP: Aortic insufficiency due to rupture by strain of a normal aortic valve, Canad. M. A. J. 19: 12, 1928. MedlineGoogle Scholar2. Carroll D: Non-traumatic aortic valve rupture, Bull. Johns Hopkins Hosp. 89: 309, 1951. MedlineGoogle Scholar3. GelfandBellet DS: The musical murmur of aortic insufficiency, Am. J. M. Sc. 221: 644, 1951. CrossrefMedlineGoogle Scholar4. PhillipsEastonFulton RWFWMN: Spontaneous rupture of the aortic valve, Rhode Island M. J. 32: 549, 1949. MedlineGoogle Scholar5. KissaneKoonsClark RWRATE: Traumatic rupture of the aortic valve, Am. J. Med. 4: 606, 1948. CrossrefMedlineGoogle Scholar6. BeanMohaupt WBFX: Rupture of aortic valve, J. A. M. A. 150: 92, 1952. CrossrefMedlineGoogle Scholar7. BeanSchmidt WBMC: Rupture of the aortic valve, J. A. M. A. 153: 214, 1953. 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AmrominSchlichterSolway GDJGAJ: Medionecrosis of the aorta, Arch. Path. 46: 380, 1948. Google Scholar16. Schlichter JG: Experimental medionecrosis of the aorta, Arch. Path. 42: 182, 1946. Google Scholar17. Gore I: Pathogenesis of dissecting aneurysm of the aorta, Arch. Path. 53: 142, 1952. Google Scholar18. Rottino A: Medial degeneration of the aorta, Arch. Path. 28: 377, 1939. Google Scholar19. BelletGouleyNicholsMcMillan SBCFTM: Loud, musical, diastolic murmurs of aortic insufficiency, Am. Heart J. 18: 483, 1939. CrossrefGoogle Scholar20. BaerTaussigOppenheimer RWHBEH: Congenital aneurysmal dilatation of the aorta associated with arachnodactyly, Bull. Johns Hopkins Hosp. 72: 309, 1943. Google Scholar21. TobinBayHumphreys JREBEM: Marfan's syndrome in the adult, Arch. Int. Med. 80: 475, 1947. CrossrefGoogle Scholar22. TungLiebow HAA: Marfan's syndrome, Lab. Invest. 1: 382, 1952. MedlineGoogle Scholar23. UyeyamaKondoKamins HBM: Arachnodactylia and cardiovascular disease: report of an autopsied case with a summary of previously autopsied cases, Am. Heart J. 34: 580, 1947. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Jackson, Mississippi*Received for publication August 16, 1954.From the Medical Service, Veterans Administration Center, Jackson, Mississippi. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySpontaneous dehiscence of an aortic commissure complicating idiopathic aortic root dilatationErworbene HerzklappenfehlerDie AorteninsuffizienzSpontaneous Aortic Cusp Rupture Associated with Valvular Myxomatous TransformationComplex shape and variability of the diastolic murmur of aortic regurgitationSymptomatic Valvular Myxomatous Transformation (The Floppy Valve Syndrome)Ruptured aortic cusp associated with an heritable disorder of connective tissueMarfan's syndrome 1 November 1955Volume 43, Issue 5Page: 1107-1115KeywordsAortaAortic valveAsphyxiaAuscultationDyspneaEndocarditisEtiologyMedical servicesSyphilisThorax ePublished: 1 December 2008 Issue Published: 1 November 1955 PDF downloadLoading ...

The importance of a high-pitched squeaking systolic murmur in the diagnosis of aortic stenosis and calcification of the aortic valve.

THE primary purpose of this report is to emphasize the relation of a high-pitched "squeaking" or "musical" systolic murmur to aortic stenosis and calcification of the aortic valve. This is not so widely appreciated as it should be, for we have found that a high-pitched musical systolic murmur is more often attributed to obscure causes than to aortic valvular disease. Some writers1 , 2 even suggest that musical murmurs are not significant.It is rather surprising that this frequent and almost specific tonal quality of the murmur of aortic stenosis receives little emphasis in clinical teaching. No mention of it is found . . .

CARDIAC ANEURYSM

Article1 July 1940CARDIAC ANEURYSMA Report of Ten Cases*WILHELM DRESSLER, M.D., ROBERT PFEIFFER, M.D.WILHELM DRESSLER, M.D.Search for more papers by this author, ROBERT PFEIFFER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-14-1-100 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptINTRODUCTIONCardiac aneurysm is not a rare finding on postmortem examination. Clinicians of the older generations were well aware of this and, in view of the seriousness of the condition, their eager search for clinical signs and symptoms by which it might be recognized during life was easily understandable.Beginning with the middle of the last century, numerous medical reports are available, referring particularly to the findings by physical examination. amination. Huchard1suggested that a very large area of cardiac dullness in subjects affected by arteriosclerosis might point towards the existence of a cardiac aneurysm. Abnormal sounds and musical murmurs,...