Eponymous cardiac murmurs

The clinical features and mechanisms of murmurs named after famous clinicians of the past.

 Cardiology  MRCP  PACES

Still'sAustin FlintGraham SteellCarey CoombsGallavardin phenomenon
clinical findingstwangy, musical, murmur in childrenLow-pitched mid-diastolic (may be pre-systolic) rumbling murmur at apex.early diastolic murmur, left sternal edge, 2nd intercostal space in inspirationshort, mid-diastolic rumble at the apex with S3 gallop. i.e. similar to mitral stenosis but disappears as the valvitis settles.the ejection systolic murmur of aortic stenosis is 'harsh' at the upper right sternal edge but 'musical' at the apex
valve diseaseFunctional murmur. Not associated with any abnormality.Severe aortic regurgitationpulmonary regurgitationmitral valvitis in rheumatic feveraortic stenosis
mechanismpossibly vibration of parts of the aortic valveaortic regurgitation flow onto endocardiumhigh velocity flow across the pulmonary valve usually associated with pulmonary hypertensionblood flow across a thickened mitral valvethe high frequency sounds are more selectively transmitted upstream from the turbulence of the valve
named afterGeorge Frederic Still, UK's first professor of childhood medicine at Great Ormond Street Hospital. Early 20th century 'father of British paediatrics'19th century American physician Austin Flint. President of American Medical Association.Graham Steell, physician, presented the murmur in Manchester in 1888Carey Franklin Coombs, early 20th century British cardiologist. Worked in Bristol.French physicians Louis Gallavardin (and M. Pauper-Ravault) in their 1925 paper.
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Murmurs with names make for great debate in medical examinations but rarely occur in clinical practice (except, perhaps, for the Gallavardin phenomenon). Today the number recognised before an echocardiogram has been reported is probably quite small.


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