The Girl with Systolic Murmur on the Left Sternal Border

2009 ◽  
pp. 63-67
Author(s):  
Mats Börjesson ◽  
Mikael Dellborg
Keyword(s):  
Systolic Murmur ◽  
Sternal Border

scholarly journals A case report showing unusual atrial communication with severe regurgitation of multiple valves and pulmonary aneurysm: double atrial septum with persistent interatrial space

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
José Antonio Ortiz de Murua ◽  
Laura de la Fuente Blanco ◽  
Alberto Trigo-Bautista ◽  
María José Ruiz-Olgado
Keyword(s):  
Case Report ◽  
Pulmonary Artery ◽  
Pulmonary Regurgitation ◽  
Artery Aneurysm ◽  
Transoesophageal Echocardiography ◽  
Atrial Septum ◽  
Systolic Murmur ◽  
Pulmonary Artery Aneurysm ◽  
First Case ◽  
Sternal Border

Abstract Background We discuss an unusual association: double atrial septum, pulmonary artery aneurysm, and severe regurgitation of multiple valves. Case summary A 70-year-old man was admitted into the hospital because of progressive dyspnoea. Physical examination showed a blood pressure of 132/70 mmHg, a systolic murmur on the right upper sternal border, another systolic murmur at the apex, and a diastolic murmur at the lower left sternal border. Electrocardiogram revealed atrial fibrillation and complete left bundle branch block. Transthoracic echocardiography showed mitral prolapse, severe mitral, aortic, and pulmonary regurgitation, a 60 mm diameter pulmonary artery aneurysm, mild to moderate tricuspid regurgitation, and moderate pulmonary hypertension. Transoesophageal echocardiography also showed an unusual atrial communication consisting of a double atrial septum with a mid-line chamber between both atria. A cardiac magnetic resonance scan was performed and confirmed echocardiography findings and QP:QS ratio = 1.3. Discussion In our knowledge, this is the first case report with this association. We present the main clinical features of the double atrial septum with persistent interatrial space, its echocardiography anatomy, differential diagnosis, and embryology.

scholarly journals Secundum Atrial Septal Defect Before and After Surgery

2018 ◽  
Vol 29 (9-10) ◽  
pp. 199-208 ◽  
Author(s):  
Bambang Madiyono ◽  
Ismet N. Oesman ◽  
Sudigdo Sastroasmoro ◽  
Sukman Tulus Putra ◽  
Eva Jeumpa Soelaeman ◽  
...  
Keyword(s):  
Atrial Septal Defect ◽  
Right Bundle Branch Block ◽  
Septal Defect ◽  
Heart Sound ◽  
Systolic Murmur ◽  
Right Atrial ◽  
Secundum Atrial Septal Defect ◽  
Bundle Branch Block ◽  
Sternal Border ◽  
Septal Motion

Twenty patients with secundum atrial septal defect, who had undergone open heart surgery were studied retrospectively. Girls were more affected than boys; the sex ratio was 1.5 : I. Associated cardiac defects were diagnosed in two patients, one with moderate valvular pulmonic stenosis and the other one with small ventricular septal defect. Typical clinical findings consisted of loud first heart sound, widely fixed split second heart sound and soft ejection systolic murmur at the upper left sternal border were heard in all cases. Mid diastolic murmur due to relative tricuspid stenosis was detected in most cases (75%). Electrocardiographic findings included right axis deviation, prolonged PR-interval and right atrial enlargement were found in 50%, 15% and 60% of cases, respectively. Incomplete right bundle branch block and right ventricular enlargement were found in all cases, as was cardiomegaly with increased vascular markings were found in all cases. Paradoxical ventricular septal motion and visualization of the atrial septal defect were seen in 95% and 75% of cases, respectively. Cardiac catheterization was performed in 19 patients (95%). The pulmonary-systemic flow ratio (Qp/Qs) ranged from 1.7 to 6.3 (mean 2.9 ± 0.67), and was correlated to the presence of mid diastolic tricuspid flow murmur and paradoxical ventricular septal motion. Simple closure of the defect was the procedure of choice, but in one patient (5%) pericardial patch was used to close the very large defect. The mortality rate was 10 percent. Physical retardation was found in all boys and 50% of girls, before surgery. Body weight percentile increased in most cases (61.1 %), while body height percentile increased in only 5.6% of cases, postoperatively. Ejection systolic murmur at the upper left sternal border was still detected in one patient (5.6%). lncomplele right bundle branch block persisted in all cases, while cardiomegaly was still found in 5. 6% of cases followed up six months to five years after surgery. There was no residual left ventricular dysfunction in all cases.

Lessons Learned from Patients: Two Cases

1979 ◽  
Vol 1 (5) ◽  
pp. 153-154
Author(s):  
JAMES E. STRAIN
Keyword(s):  
Physical Examination ◽  
Lymph Nodes ◽  
Nasal Congestion ◽  
Lessons Learned ◽  
Systolic Murmur ◽  
Cervical Lymph Nodes ◽  
White Girl ◽  
Sternal Border ◽  
The Right

A 4-year-old white girl was entirely well until Jan 8, 1979, when her temperature was 104 F. Other symptoms included nasal congestion, slight cough, and pain in the right ear. On physical examination her right ear drum was moderately inflamed and bulging. Her tonsils were large and red, but no exudate was present. Tender anterior cervical lymph nodes, 2 x 2 cm, were palpable bilaterally. Her chest was clear. There was a grade 1/6 systolic murmur along the left sternal border (LSB) which had been heard on previous examinations and was thought to be innocent in nature. Her spleen was not palpable.

The Syndrome Associated with Mid-systolic Click and/or Late Systolic Murmur

CHEST Journal ◽  
1971 ◽  
Vol 59 (6) ◽  
pp. 643-647 ◽  
Author(s):  
Robert M. Jeresaty
Keyword(s):  
Systolic Murmur

scholarly journals PATIENT WITH A SYSTOLIC MURMUR AND SHOCK: IMPORTANCE OF THE PHYSICAL

2017 ◽  
Vol 69 (11) ◽  
pp. 2361
Author(s):  
Mahwash Kassi ◽  
Eleonora Avenatti ◽  
Stephen Little ◽  
Gerald Lawrie ◽  
William Zoghbi
Keyword(s):  
Systolic Murmur

The atypical systolic murmur of minute ventricular septal defect and its recognition by amyl nitrite and phenylephrine

1961 ◽  
Vol 62 (1) ◽  
pp. 101-118 ◽  
Author(s):  
L. Vogelpoel ◽  
V. Schrire ◽  
W. Beck ◽  
M. Nellen ◽  
A. Swanepoel
Keyword(s):  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Systolic Murmur ◽  
Amyl Nitrite

The Effect of Isometric Exercise on the Systolic Murmur of Patients with Idiopathic Hypertrophic Subaortic Stenosis

CHEST Journal ◽  
1975 ◽  
Vol 67 (4) ◽  
pp. 395-397 ◽  
Author(s):  
John Cassidy ◽  
Wilbert S. Aronow ◽  
Ravi Prakash
Keyword(s):  
Isometric Exercise ◽  
Systolic Murmur ◽  
Subaortic Stenosis

scholarly journals PHONOCARDIOGRAPHIC FEATURES OF THE SYSTOLIC MURMUR IN PULMONARY ARTERY STENOSIS

Heart ◽  
1965 ◽  
Vol 27 (3) ◽  
pp. 374-378 ◽  
Author(s):  
G. Bousvaros ◽  
W. Palmer
Keyword(s):  
Pulmonary Artery ◽  
Artery Stenosis ◽  
Systolic Murmur ◽  
Pulmonary Artery Stenosis

scholarly journals A systolic murmur is a common presentation of aortic regurgitation detected by echocardiography

2004 ◽  
Vol 27 (9) ◽  
pp. 502-506 ◽  
Author(s):  
Paul A. Heidenreich ◽  
Ingela Schnittger ◽  
Stsven L. Hancock ◽  
J. Edwin Atwood
Keyword(s):  
Aortic Regurgitation ◽  
Systolic Murmur ◽  
Common Presentation
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