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M. Alam, A. Madrazo, D. Magilligan, S. Goldstein (1979)
M mode and two dimensional echocardiographic features of porcine valve dysfunction.The American journal of cardiology, 43 3
M. Alam, S. Goldstein (1980)
Echocardiographic features of flail aortic porcine valve.Chest, 78 1
P. Stein, H. Sabbah, D. Magilligan, J. Lakier (1982)
Mechanism of a musical systolic murmur caused by a degenerated porcine bioprosthetic valve.The American journal of cardiology, 49 8
K. Venkataraman, R. Siegel, S. Kim, J. Allen (1978)
Musical murmurs: an echo-phonocardiographic study.The American journal of cardiology, 41 5
E. Harrison, S. Sbar, E. Spoto, P. Clark (1980)
Echocardiogram in porcine mitral valve dysfunction.The American journal of cardiology, 45 4
Jonathan F. Plehn, MD, and Philip R. Liebson, MD The onset of a loud apical systolic murmur is highly suggestive of valvular incompetence in a patient with a bioprosthetic mitral valve. This may be caused by a transvalvular or perivalvular leak. We recently were able to establish the specific cause of such a murmur through the use of m-mode echo-phonocardiography. CASE REPORT A 50-year-old white woman complained of progressive dyspnea on exertion, pedal edema, and a new âhonkingâ sound in her chest. She had received a porcine bioprosthetic mitral valve replacement for severe mitral stenosis 3% years previously. She had been asymptomatic since that time. On physical examination, the patient was a slightly cachectic woman in no apparent distress. Her neck veins were engorged to the level of the mandible and bilateral basilar rales were appreciated. The point of maximal cardiac impulse was at the sixth intercostal space, 2 cm medial to the anterior axillary line and an apical thrill was easily palpable. There was a changing irregular rhythm, a decreased S1,and S2 was obscured by a grade six holosystolic honking murmur heard best at the apex but radiating across the precordium to the axilla. The patient also
Journal of Clinical Ultrasound – Wiley
Published: Feb 1, 1984
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