Pulmonary regurgitation

Pulmonary regurgitation Pulmonary regurgitation (PR) can be divided into hypertensive and non-hypertensive. The former is associated with pulmonary arterial hypertension while the latter is not. Hypertensive pulmonary regurgitation Hypertensive PR is associated with severe pulmonary hypertension. It produces a blowing, decrescendo early diastolic murmur with the eponym Graham Steell murmur [1]. The murmur is heard in the pulmonary area and left sternal border, resembling the murmur of aortic regurgitation. It may be heard in Eisenmenger syndrome, severe primary pulmonary hypertension and severe pulmonary hypertension secondary to left heart disease like severe mitral stenosis. The murmur starts early in diastole after the loud pulmonary component of the second heart sound. A mid diastolic and presystolic murmur known as right sided Austin Flint murmur [2,3] may sometimes be associated. Non hypertensive PR Pulmonary regurgitation can occur without pulmonary hypertension in: Infective endocarditis – perforation and other types of damage After repair tetralogy of Fallot, especially with a transannular patch After surgical or percutaneous relief of pulmonary stenosis Absent pulmonary valve – though usually associated with tetralogy of Fallot, can occur in isolation. Carcinoid syndrome involving mainly the right sided valves Rheumatic heart disease. Rheumatic fever can very rarely can involve the pulmonary valve. Since the hemodynamic load is least on the pulmonary v...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Graham Steell murmur hypertensive PR hypertensive pulmonary regurgitation non hypertensive PR non hypertensive pulmonary regurgitation right sided Austin Flint murmur Source Type: blogs