Diastolic murmur- Pulmonary valve opening sound

2021-03-15 12:00 AM

The pulmonary valve leaking sound is caused by a dysfunction of the pulmonary valve leaf allowing blood to flow backwards from the pulmonary artery to the right ventricle during diastole. 

Description

In the absence of severe pulmonary hypertension, the murmur is described as a diastolic, gradual decrease in intensity, audible in the 3 or 4 intercostal space on the left sternum. As with right-heart-induced murmurings, it increases in intensity on inhalation.

Reason

Frequent

Pulmonary hypertension - a common cause, especially when Eisenmenger syndrome occurs.

Fallot quadriplegic after surgery because the pulmonary valve was cut.

Pulmonary artery dilatation - a primary or secondary condition caused by connective tissue disease (eg Marfan Syndrome).

Endocarditis of infection.

Less common

Congenital structural abnormalities of the valve leaf apparatus.

Rheumatic heart disease - rare.

Carcinoid syndrome - rare.

Mechanism

The pulmonary valve leaking sound is caused by a dysfunction of the pulmonary valve leaf allowing blood to flow backwards from the pulmonary artery to the right ventricle during diastole.

Regardless of the underlying condition, it can be caused by:

Pulmonary valve dilatation.

Pulmonary artery dilatation.

Abnormal valve leaf shape.

Congenital valve-related abnormalities.

Dilation of the valve rings is a consequence of chronic pulmonary hypertension, which is a common cause and mechanism.

Pulmonary artery dilatation, which results in the pulmonary artery being too large for the valve apparatus, can be either primary or in connective tissue disease.

Meaning

Mild pulmonary valve stenosis is common in the community. However, the apparent appearance of a murmur increases the likelihood of a pulmonary valve leaking, LR 17.0.

Without murmur, pulmonary valve regurgitation cannot be ruled out, NLR 0.9.