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      Presystolic Mitral Regurgitation in Severe Aortic Incompetence Observed by Cineangiography

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          Abstract

          Four patients with severe isolated aortic regurgitation following bacterial endocarditis showed an early diastolic ‘functional mitral stenosis’ with a maximal pressure difference across the valve of 5–20 mm Hg. At the end of diastole, the left ventricular pressure exceeded the left atrial pressure, and the peak pressure difference varied between 13 and 33 mm Hg. In two of these patients a presystolic mitral regurgitation was observed on cineangiography when contrast medium was injected into the ascending aorta. In a case with complete atrioventricular block, presystolic mitral regurgitation was observed only at a low ventricular rate but not when the ventricular rate was increased by pacing. Two types of low frequency apical diastolic murmurs were observed: one in early diastole during the phase of ‘functional mitral stenosis’ (in one case only) and a presystolic murmur during the phase of reversed pressure differences (in all cases). The later type of murmur may be explained by presystolic mitral regurgitation, which was demonstrated on cineangiography in two of the four patients. This presystolic ‘functional’ mitral regurgitation must be distinguished on the angiogram from a true systolic regurgitation caused by diseased valve leaflets.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1973
          1973
          29 October 2008
          : 58
          : 6
          : 347-354
          Affiliations
          Departments of Cardiology, Clinical Physiology, and Thoracic Radiology at the Thoracic Clinics, Karolinska Sjukhuset, Stockholm
          Article
          169652 Cardiology 1973;58:347–354
          10.1159/000169652
          4803088
          © 1973 S. Karger AG, Basel

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          Page count
          Pages: 8
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