In
cardiology
Cardiology () is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular h ...
, an Austin Flint murmur is a low-pitched rumbling
heart murmur
Heart murmurs are unique heart sounds produced when blood flows across a heart valve or blood vessel. This occurs when turbulent blood flow creates a sound loud enough to hear with a stethoscope. Turbulent blood flow is not smooth. The sound di ...
which is best heard at the
cardiac apex. It can be a mid-diastolic
[Eric J. Topol]
The Topol Solution: Textbook of Cardiovascular Medicine
Third Edition with DVD, Plus Integrated Content Website, Volume 355. Lippincott Williams & Wilkins, Oct 19, 2006; page 223. or
presystolic murmur
A presystolic murmur, also called presystolic accentuation, is a type of diastolic heart murmur typically associated with the opening snap in mitral valve stenosis. It is heard following the middiastolic rumble of the stenotic valve,Eric J. Topol ...
It is associated with severe
aortic regurgitation
Aortic regurgitation (AR), also known as aortic insufficiency (AI), is the leaking of the aortic valve of the heart that causes blood to flow in the reverse direction during ventricular diastole, from the aorta into the left ventricle. As a cons ...
, although the role of this sign in clinical practice has been questioned.
[
]
Mechanism
Echocardiography
An echocardiography, echocardiogram, cardiac echo or simply an echo, is an ultrasound of the heart.
It is a type of medical imaging of the heart, using standard ultrasound or Doppler ultrasound.
Echocardiography has become routinely used in ...
, conventional and colour flow
Doppler ultrasound, and cine
nuclear magnetic resonance (cine NMR) imaging suggest the murmur is the result of (aortic regurgitant) flow impingement on the inner surface of the heart, i.e. the
endocardium
The endocardium is the innermost layer of tissue that lines the chambers of the heart. Its cells are embryologically and biologically similar to the endothelial cells that line blood vessels. The endocardium also provides protection to the va ...
.
[
]
Classical description
Classically, it is described as being the result of
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 on ...
leaflet displacement ''and'' turbulent mixing of anterograde
mitral
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 o ...
flow and retrograde
aortic
The aorta ( ) is the main and largest artery in the human body, originating from the left ventricle of the heart and extending down to the abdomen, where it splits into two smaller arteries (the common iliac arteries). The aorta distributes ox ...
flow:
Displacement: The
blood
Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the cir ...
jets from the aortic regurgitation strike the anterior leaflet of the
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 on ...
, which often results in premature closure of the mitral leaflets. This can be mistaken for mitral stenosis.
Turbulence of the two columns of blood: Blood from
left atrium to left ventricle and blood from aorta to
left ventricle
A ventricle is one of two large chambers toward the bottom of the heart that collect and expel blood towards the peripheral beds within the body and lungs. The blood pumped by a ventricle is supplied by an atrium, an adjacent chamber in the uppe ...
.
Name
The Austin Flint murmur is
named after
A namesake is a person, geographic location, or other entity bearing the name of another.
History
The word is first attested around 1635, and probably comes from the phrase "for one's name's sake",
which originates in English Bible translations ...
the 19th century
American
American(s) may refer to:
* American, something of, from, or related to the United States of America, commonly known as the "United States" or "America"
** Americans, citizens and nationals of the United States of America
** American ancestry, pe ...
physician
A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
,
Austin Flint
Austin Flint I (October 20, 1812 – March 13, 1886) was an American physician. He was a founder of Buffalo Medical College, precursor to The State University of New York at Buffalo. He served as president of the American Medical Association.
...
(1812–1886). He disapproved of associating any physical sign with the name of the original describer, and wrote, "So long as signs are determined from fancied analogies, and named from these or after the person who describes them, there cannot but be obscurity and confusion."
References
{{Cardiovascular system symptoms and signs
Heart murmurs