Carey Coombs Murmur
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Carey Coombs Murmur
The Carey Coombs murmur or Coombs murmur is a clinical sign which occurs in patients with mitral valvulitis due to acute rheumatic fever. It is described as a short, mid-diastolic rumble best heard at the apex, which disappears as the valvulitis improves. It is often associated with an S3 gallop rhythm, and can be distinguished from the diastolic murmur of mitral stenosis by the absence of an opening snap before the murmur. It is audible at apex. The murmur is caused by increased blood flow across a thickened mitral valve.John Willis Hurst, Valentin Fuster, R. Wayne Alexander. ''Hurst's the Heart,'' page 1637. McGraw-Hill Professional, 2001. . The sign is named after Carey Coombs Carey Franklin Coombs (5 September 1879 – 9 December 1932) was a British cardiologist known for his work involving rheumatic heart disease and the eponymous Carey Coombs murmur. Early life and education Coombs was born in Castle Cary, So ... who was a British cardiologist. References H ...
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Medical Sign
Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showing on a medical scan. A symptom is something out of the ordinary that is experienced by an individual such as feeling feverish, a headache or other pain or pains in the body. Signs and symptoms Signs A medical sign is an objective observable indication of a disease, injury, or abnormal physiological state that may be detected during a physical examination, examining the patient history, or diagnostic procedure. These signs are visible or otherwise detectable such as a rash or bruise. Medical signs, along with symptoms, assist in formulating diagnostic hypothesis. Examples of signs include elevated blood pressure, nail clubbing of the fingernails or toenails, staggering gait, and arcus senilis and arcus juvenilis of the eyes. Indicati ...
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Rheumatic Fever
Rheumatic fever (RF) is an inflammatory disease that can involve the heart, joints, skin, and brain. The disease typically develops two to four weeks after a streptococcal throat infection. Signs and symptoms include fever, multiple painful joints, involuntary muscle movements, and occasionally a characteristic non-itchy rash known as erythema marginatum. The heart is involved in about half of the cases. Damage to the heart valves, known as rheumatic heart disease (RHD), usually occurs after repeated attacks but can sometimes occur after one. The damaged valves may result in heart failure, atrial fibrillation and infection of the valves. Rheumatic fever may occur following an infection of the throat by the bacterium ''Streptococcus pyogenes''. If the infection is left untreated, rheumatic fever occurs in up to three percent of people. The underlying mechanism is believed to involve the production of antibodies against a person's own tissues. Due to their genetics, some peo ...
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Apex Of The Heart
The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide to the lungs. In humans, the heart is approximately the size of a closed fist and is located between the lungs, in the middle compartment of the chest. In humans, other mammals, and birds, the heart is divided into four chambers: upper left and right atria and lower left and right ventricles. Commonly the right atrium and ventricle are referred together as the right heart and their left counterparts as the left heart. Fish, in contrast, have two chambers, an atrium and a ventricle, while most reptiles have three chambers. In a healthy heart blood flows one way through the heart due to heart valves, which prevent backflow. The heart is enclosed in a protective sac, the pericardium, which also contains a small amount of fluid. The wall of t ...
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Third Heart Sound
The third heart sound or S3 is a rare extra heart sound that occurs soon after the normal two "lub-dub" heart sounds (S1 and S2). S3 is associated with heart failure. Physiology It occurs at the beginning of the middle third of diastole, approximately 0.12 to 0.18 seconds after S2. This produces a rhythm classically compared to the cadence of the word "Kentucky" with the final syllable ("''-CKY''") representing S3. One may also use the phrase "Slosh’-ing-IN" to help with the cadence (Slosh S1, -ing S2, -in S3), as well as the pathology of the S3 sound, or any other number of local variants. S3 may be normal in people under 40 years of age and some trained athletes but should disappear before middle age. Re-emergence of this sound late in life is abnormal and may indicate serious problems like heart failure. The sound of S3 is lower in pitch than the normal sounds, usually faint, and best heard with the bell of the stethoscope. It has also been termed a ventricular gallop or a ...
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Gallop Rhythm
A gallop rhythm refers to a (usually abnormal) rhythm of the heart on auscultation. It includes three or four sounds, thus resembling the sounds of a gallop. The normal heart rhythm contains two audible heart sounds called S1 and S2 that give the well-known "lub-dub" rhythm; they are caused by the closing of valves in the heart. The first heart sound (S1) is closure of the valve at the end of ventricular filling (the tricuspid and mitral valves); the second heart sound (S2), is closure of the aortic and/or the pulmonary valves as the ventricles relax. Extra sounds, (third and/or fourth heart sound, can be normal, especially in children, or with severe exercise, but are generally heard (on the left side) when ventricular function is impaired, e.g., in case of acute infarction or severe cardiac failure. The sounds are thought to be caused by the atrium, facing back-pressure, forcing volume into an incompletely emptied ventricle. Then, given tachycardia, a "gallop" is produced. Wi ...
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Mitral Stenosis
Mitral stenosis is a valvular heart disease characterized by the narrowing of the opening of the mitral valve of the heart. It is almost always caused by rheumatic valvular heart disease. Normally, the mitral valve is about 5 cm2 during diastole. Any decrease in area below 2 cm2 causes mitral stenosis. Early diagnosis of mitral stenosis in pregnancy is very important as the heart cannot tolerate increased cardiac output demand as in the case of exercise and pregnancy. Atrial fibrillation is a common complication of resulting left atrial enlargement, which can lead to systemic thromboembolic complications like stroke. Signs and symptoms Signs and symptoms of mitral stenosis include the following: * Heart failure symptoms, such as dyspnea on exertion, orthopnea and paroxysmal nocturnal dyspnea (PND) * Palpitations * Chest pain * Hemoptysis * Thromboembolism in later stages when the left atrial volume is increased (i.e., dilation). The latter leads to increase risk of ...
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Mitral Valve
The mitral valve (), also known as the bicuspid valve or left atrioventricular valve, is one of the four heart valves. It has two cusps or flaps and lies between the left atrium and the left ventricle of the heart. The heart valves are all one-way valves allowing blood flow in just one direction. The mitral valve and the tricuspid valve are known as the atrioventricular valves because they lie between the atria and the ventricles. In normal conditions, blood flows through an open mitral valve during diastole with contraction of the left atrium, and the mitral valve closes during systole with contraction of the left ventricle. The valve opens and closes because of pressure differences, opening when there is greater pressure in the left atrium than ventricle and closing when there is greater pressure in the left ventricle than atrium. In abnormal conditions, blood may flow backward through the valve ( mitral regurgitation) or the mitral valve may be narrowed (mitral stenosis). Rh ...
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Carey Coombs
Carey Franklin Coombs (5 September 1879 – 9 December 1932) was a British cardiologist known for his work involving rheumatic heart disease and the eponymous Carey Coombs murmur. Early life and education Coombs was born in Castle Cary, Somerset, Frome, England on 5 September 1879. He received his early education at University College in Bristol. He then attended medical school at St. Mary's Hospital Medical School and was awarded his M.B. in 1901, M.D. in 1903. He then returned to Bristol to enter private practice. He was made a Fellow of the Royal College of Physicians in 1917. He became a physician at Bristol General Hospital in 1920 and director of the Bristol University Centre of Cardiac Research in 1927. During World War I he was a major in the Royal Army Medical Corps and served in England, Egypt, Mesopotamia and France. Contributions to medicine He is best known for his work involving rheumatic and coronary heart disease. He performed important studies of rheu ...
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