A Graham Steell murmur is a
heart murmur typically associated with
pulmonary regurgitation
Pulmonary (or pulmonic) insufficiency (or incompetence, or regurgitation) is a condition in which the pulmonary valve is incompetent and allows backflow from the pulmonary artery to the right ventricle of the heart during diastole. While a small a ...
. It is a high pitched
early diastolic
Early may refer to:
History
* The beginning or oldest part of a defined historical period, as opposed to middle or late periods, e.g.:
** Early Christianity
** Early modern Europe
Places in the United States
* Early, Iowa
* Early, Texas
* Early ...
murmur heard best at the left sternal edge in the second
intercostal space with the patient in full
inspiration
Inspiration, inspire, or inspired often refers to:
* Artistic inspiration, sudden creativity in artistic production
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, originally described in 1888.
The murmur is heard due to a high
velocity
Velocity is the directional speed of an object in motion as an indication of its rate of change in position as observed from a particular frame of reference and as measured by a particular standard of time (e.g. northbound). Velocity is a ...
flow back across the
pulmonary valve; this is usually a consequence of
pulmonary hypertension secondary to
mitral valve stenosis. The Graham Steell murmur is often heard in patients with chronic
cor pulmonale (pulmonary heart disease) as a result of
chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough, which may or may not produce ...
.
In cases of mitral obstruction the murmur is occasionally heard over the pulmonary area and below this region, for the distance of an inch or two along the left border of the sternum.
It's also rarely over the lowest part of the bone itself, a soft blowing diastolic murmur immediately following P2.
It is named after
Graham Steell.
References
Heart murmurs
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