Carvallo's sign is a clinical sign found in patients with

tricuspid regurgitation Tricuspid regurgitation (TR), also called tricuspid insufficiency, is a type of valvular heart disease in which the tricuspid valve of the heart, located between the right atrium and right ventricle, does not close completely when the right ventr ...

. The pansystolic murmur found in this condition becomes louder during inspiration; this sign enables it to be distinguished from mitral regurgitation.

Pathophysiology

During inspiration, the venous blood flow into the

right atrium The atrium ( la, ātrium, , entry hall) is one of two upper chambers in the heart that receives blood from the circulatory system. The blood in the atria is pumped into the heart ventricles through the atrioventricular valves. There are two at ...

and ventricle are increased, which increases the stroke volume of the right ventricle during systole. As a result, the leak of blood from the right ventricle into the right atrium is larger during inspiration, causing the murmur to become louder. During expiration, the leak of blood backwards through the

tricuspid valve The tricuspid valve, or right atrioventricular valve, is on the right dorsal side of the mammalian heart, at the superior portion of the right ventricle. The function of the valve is to allow blood to flow from the right atrium to the right ven ...

is lessened, making the murmur more quiet. Conversely, the murmur of mitral regurgitation becomes louder during expiration due to the increase in venous return from the

pulmonary vein The pulmonary veins are the veins that transfer oxygenated blood from the lungs to the heart. The largest pulmonary veins are the four ''main pulmonary veins'', two from each lung that drain into the left atrium of the heart. The pulmonary vei ...

s to the left heart.

Eponym

The sign is named after José Manuel Rivero Carvallo.Rivero-Carvallo JM. Signo para el diagnóstico de las insuficiencias tricuspideas. ''Archivos del Instituto de cardiologia de Mexico'', 1946, 16: 531.

References

External links

Medical signs Cardiovascular diseases {{med-sign-stub