Diastolic murmur - some signs of aortic valve regurgitation

Signal

Description

Mechanism

Meaning

Austin Flint blowing sound

The low-frequency blowing sound, which sounds like a machine running, begins in the middle of the diastole and ends at the end of the diastolic period. The murmur is heard clearly at the tip of the heart when the patient sits forward and exhales as hard as she can. The patient does not have an accompanying mitral stenosis

Assumptions about the mechanism are as follows:

The aortic regurgitation blood flows to the mitral valve leaf, resulting in the formation of mitral stenosis.

The mitral valve vibrates due to the backflow of the aortic valve regurgitation.

The endocardium vibrates due to the backflow of the aortic valve regurgitation

There are different opinions about the meaning of a sign:

Austin Flint murmur is commonly seen in severe aortic valve regurgitation and has a wide jump amplitude from 25% to 100%, depending on the study. Another suggestion is that the presence of the Austin Flint murmur is an indicator of moderate to severe aortic valve regurgitation with an LR of 25.

Becker sign

Retinal artery beats

There is little evidence

Corrigan sign

The circuit bounces rapidly with large amplitudes noticeable when capturing the peripheral circuit

Increases the tension in the vessel walls

Corrigan marker of limited use with a sensitivity of 38–95% and a specificity of 16% in aortic regurgitation

De Musset sign

Head nodding according to the beating heartbeat

Not clear yet

There is little evidence

Dozier sign

A to-and-fro or 'machine' sound is heard in the femoral artery during diastolic and systolic periods when pressed with a stethoscope

Systolic murmur is heard by blood flow through an artery pressure; diastolic murmur heard from blood flow back to the heart

Sensitivity 35–100%, specificity 33–81% in apparent aortic regurgitation; There are no solid studies on the validity of this marker

Signs Gerhardt

Spleen pulsed

There is little evidence

 Hill Sign

The systolic blood pressure in the lower limb was higher than in the upper limb.

If the blood pressure in the lower extremities compared to the upper limb difference is more than 60mmHg or there is a difference in blood pressure between the artery/arm more than 20mmHg, then Hill sign is positive.

The mechanism is unknown

The evidence remains controversial:

A recent study found that there was no real increase in blood pressure in the lumen of the lower extremities compared with blood pressure in the upper extremities in patients with aortic regurgitation.

Another study found that the difference in blood pressure between the coronary/armoured artery helped to predict the severity of a cleft palate when the difference was> 20 mmHg with a sensitivity of 89%, but the sign did not help differentiate the regurgitation. The valve is light and does not leak.

In the prediction of an open valve, the specificity is 71–100% and the sensitivity ranges from 0% to 100%.

Mayne Sign

Diastolic blood pressure drops by more than 15mmHg when the arms are raised

There is little evidence

You Müller

Chicken tongue bounced

There is little evidence

Quincke Sign

The nail tip blinks with a pulse. It Maybe more obvious if the nail is pressed

There is little evidence

Traube sign

The sound or sounds like gunshots in the femoral artery

Due to sudden stretch in the vessel wall during the systolic period

There is little evidence