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someone please explain me what is presystolic murmur? mid diastolic,earlydiastolic murmor?
Any 'clinical methods' should give you the details. do you have any specific doubt?
i want meaning of these terminologies presystolic murmur? mid diastolic,earlydiastolic murmor?
S1 and S2 are the first and second heart sound.
The period between S1 and S2 is the systole. The period between S2 and S1 is the diastole.
Early diastolic murmurs start at the same time as S2 and typically end before S1.
Mid-diastolic murmurs start after S2 and end before S1.
Late diastolic (presystolic) murmurs start after S2 and extend up to S1 and have a crescendo configuration.
THERE ARE 4 HEART SOUND BUT USUALLY AND COMMONLY WE HERE 2 HEART SOUNDS. THESE ARE CALLED AS S1 AND S2. S1 HEART SOUND IS DUE TO THE CLOSURE OF THE ATRIOVENTRICULAR VALVES IE. MITRAL AND TRICUSPID VALVES WHILE S2 IS DUE TO CLOSURE OF SEMILUNAR VALVES IE. AORTIC AND PULMONARY VALVES. THE DURATION BETWEEN S1 AND S2 IS SYSTOLE AND BETWEEN S2 AND S1 IS DIASTOLE. DISTOLIC MURMURS CAN BE DIVIDED IN EARLY, MID AND LATE DIASTOLIC. EARLY DIASTOLIC MURMUR IS DUE TO THE SEMILUNAR IE. AORTIC AND PULMONARY VALVULAR REGURGITATION BECAUSE AORTIC AND PULMONARY PRESSURES ARE HIGHER THAN THIER RESPECTIVE VENTRICLES. MID DIASTOLIC MURMUR IS MAINLY DUE TO ATRIOVENTRICULAR VALVES STENOSIS IE. MITRAL AND TRICUSPID VALVE STENOSIS. LIKEWISE LATE DIASTOLIC MURMUR ARE ALSO COMMON IN MITRAL AND TRICUSPID VALVULAR STENOSIS AND THIS LATE MURMUR IS DE TO THE CONTRACTION OF THE ATRIA WHICH IS JUST BEFORE THE CONTRACTION OF VENTRICLES. SO THIS MURMUR CAN ALSO BE CALLED AS PRESYSTOLIC MURMUR.
SYSTOLIC MURMURS CAN ALSO BE DIVIDED IN SYSTOLIC EJECTION MURMUR AND SYSTOLIC REGURGITANT MURMURS. SYSTOLIC EJECTION MURMUR IS PRESENT IN AORTIC AND PULMONARY VALVULAR STENOSIS AND SYSTOLIC REGURGITATION MURMUR IS PRESENT IN MITRAL OR TRICUSPID VALVULAR REGURGITATION AND ALSO IN VENTRICULAR SEPTAL DEFECT. REGURGITANT MURMUR MAY BE PAN OR HOLOSYSTOLIC IN QUALITY.
thankyou for your answer
thanks,good classification but hard to read in capitals.
Early diastolic murmur :
Early diastolic murmur occupies the first part of the diastole .(early part of diastole)
Starts immediately after the second sound.
Does not extend to middle or late part of diastole.
(Diastole is duration between I and II heart sound)
Presystolic murmur is also called late diastolic murmur.
It precedes the first sound and Often ends in the first sound.
It occupies late part of diastole.
Mid diastolic murmur
Occupies middle of diastole
The murmur is separated from the second sound by a short pause
It starts immediately after the III heart sound.
In Mitral stenosis mid diastolic murmur continues as presystolic murmur.
Classical example is MDM of Mitral Stenosis with presystolic accentuation
Early diatolic murmur is ‘decrescendo” murmur
Decresendo murmur is one which goes on waning in intensity.
Classical example is Early diastolic murmur of Aortic Incompetence
Presystolic murmur is a “crescendo” murmur.
A crescendo murmur is the one which progressively increases in intensity
Classically occurs in Mitral stenosis as continuation of Mid diastolic murmur
To put it shortly
Presytolic just precedes and ends in I heart sound.In timing it is just before systole starts.hence the name.
Early diastolic murmur immediately follows the II heart sound
Mid diastolic follows III heart sound;the murmur occupies middle part of diastole.
Clinically to diagnose the murmurs one should learn first to identify and time the Iand II heart sounds.
Mid-systolic ejection murmurs are due to blood flow through the semilunar valves. They occur at the start of blood ejection — which starts after S1 — and ends with the cessation of the blood flow — which is before S2. Therefore, the onset of a midsystolic ejection murmur is separated from S1 by the isovolumic contraction phase; the cessation of the murmur and the S2 interval is the aortic or pulmonary hangout time. The resultant configuration of this murmur is a crescendo-decrescendo murmur. Causes of midsystolic ejection murmurs include outflow obstruction, increased flow through normal semilunar valves, dilation of aortic root or pulmonary trunk, or structural changes in the semilunar valves without obstruction.
Late systolic murmurs starts after S1 and, if left sided, extends up to S2, usually in a crescendo manner. Causes include mitral valve prolapse, tricuspid valve prolapse and papillary muscle dysfunction.
Holosystolic (pansystolic) murmurs start at S1 and extends up to S2. They are usually due to regurgitation in cases such as mitral regurgitation, tricuspid regurgitation, or ventricular septal defect (VSD)
Early diastolic murmurs start at the same time as S2 with the close of the semilunar (aortic & pulmonary) valves and typically end before S1. Common causes include aortic or pulmonary regurgitation and left anterior descending artery stenosis.
Mid-diastolic murmurs start after S2 and end before S1. They are due to turbulent flow across the atrioventricular (mitral & tricuspid) valves during the rapid filling phase from mitral or tricuspid stenosis.
Late diastolic (presystolic) murmurs start after S2 and extend up to S1 and have a crescendo configuration. They can be associated with AV valve narrowing. They include mitral stenosis, tricupsid stenosis, myxoma, and complete heart block.