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The "Murmur on Top of the Head" in Acquired Mitral Insufficiency

The "Murmur on Top of the Head" in Acquired Mitral Insufficiency A "murmur on top of the head" has been documented in seven patients with mitral insufficiency. Five patients revealed ruptured chordae tendineae of anterior leaflets secondary to rheumatic fever or subacute bacterial endocarditis. Two remaining patients exhibited rheumatic valvulitis and annular dilatation. The regurgitation was readily corrected by excising or plicating the flail area or posteromedial annuloplasty, or both. Survivors are asymptomatic without embolization or infection. Whether due to ruptured chordae of the aortic leaflet (usual) or valvulitis and annular dilatation (and in the absence of valvular calcification by fluoroscopy), the problem has been correctable by iow-risk reconstructive procedures without need for prosthetic valve replacement. Therefore, when this murmur is present, valuable inferences regarding etiology, pathology, surgical therapy, and prognosis can be made. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

The "Murmur on Top of the Head" in Acquired Mitral Insufficiency

JAMA , Volume 199 (12) – Mar 20, 1967

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Publisher
American Medical Association
Copyright
Copyright © 1967 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.1967.03120120080012
Publisher site
See Article on Publisher Site

Abstract

A "murmur on top of the head" has been documented in seven patients with mitral insufficiency. Five patients revealed ruptured chordae tendineae of anterior leaflets secondary to rheumatic fever or subacute bacterial endocarditis. Two remaining patients exhibited rheumatic valvulitis and annular dilatation. The regurgitation was readily corrected by excising or plicating the flail area or posteromedial annuloplasty, or both. Survivors are asymptomatic without embolization or infection. Whether due to ruptured chordae of the aortic leaflet (usual) or valvulitis and annular dilatation (and in the absence of valvular calcification by fluoroscopy), the problem has been correctable by iow-risk reconstructive procedures without need for prosthetic valve replacement. Therefore, when this murmur is present, valuable inferences regarding etiology, pathology, surgical therapy, and prognosis can be made.

Journal

JAMAAmerican Medical Association

Published: Mar 20, 1967

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