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24 Possible Causes for Mild to Severe Mitral Regurgitation, Pulsatile Liver

  • Aortic Valve Insufficiency

    […] jet Mild (grade 1 ) : The regurgitant jet extends to just beneath the aortic leaflets Moderate (grade 2 ) : The regurgitant jet extends to the tips of the mitral leaflets[echocardiology.org] liver) Gerhardt's sign (enlarged spleen) Duroziez's sign (systolic and diastolic murmurs heard over the femoral artery when it is gradually compressed) Hill's sign (A 20[doctorslounge.com] (4 ) : 65% Regurgitant jet area/LVOT area Mild(1 ) : 4% Moderate (2 ) : 4 to 24% Moderately severe (3 ) : 25 to 59% Severe (4 ) : 60% M-Mode Diastolic flutter of the anterior[echocardiology.org]

  • Tricuspid Valve Insufficiency

    Right heart failure leads to ascites, hepatosplenomegaly, pulsatile liver, peripheral edema and pleural overflow. In advanced stages patients are cachectic and cyanotic.[heartupdate.com] Fatigue, weakness, shortness of breath, jugular vein distension, ascites, hepato-splenomegaly, pulsatile liver, pleural effusions and peripheral oedema may be present.[escardio.org] The liver may be large and pulsatile. There is usually a single first heart sound that may be increased in intensity.[patient.info]

  • Jugular Venous Distention

    Tricuspid regurgitation, if significant, will be accompanied by a pulsatile liver (feel over the lower costal margin).[stanfordmedicine25.stanford.edu]

  • Pulmonary Hypertension

    The signs of right ventricular failure include a high-pitched systolic murmur of tricuspid regurgitation, hepatomegaly, a pulsatile liver, ascites, and peripheral edema.[emedicine.medscape.com]

  • Endocarditis

    On examination, there was a loud holosystolic murmur, maximally audible in the epigastric space, and a pulsatile liver.[the-hospitalist.org]

  • Acute Aortic Regurgitation

    […] nailbed) • Palfrey’s sign ( pistol shot sounds in radial artery ) • Rosenbach’s sign (pulsations in liver) • Gerhart’s sign ( pulsations in spleen ) • Traube’s sign (Pistol[slideshare.net] […] of the left ventricle and mild-to-moderate diastolic mitral regurgitation.[ncbi.nlm.nih.gov] […] head bobs with heart beat) • Corrigan’s sign ( Dancing carotids ) • Muller’s sign (systolic pulsation of uvula) • Corrigan’s pulse (water hammer pulse) • Quninckey’s sign (pulsatile[slideshare.net]

  • Pulmonary Valve Disease

    The pulsatile liver is a sign of severe regurgitation.[revespcardiol.org] Severe tricuspid regurgitation usually requires surgery to be performed in association with mitral valve surgery.[ncbi.nlm.nih.gov] The liver is enlarged with a firm edge, and pulsatile in presystole. Auscultation reveals a low-to-medium-pitched diastolic rumble with inspiratory accentuation.[revespcardiol.org]

  • Pulmonary Edema

    A 25 year old primigravida parturient with severe mitral stenosis, mild mitral regurgitation, mild aortic regurgitation, and mild pulmonary arterial hypertension required[ncbi.nlm.nih.gov] […] is enlarged and may be tender or even pulsatile.[en.wikipedia.org] […] legs, in general, of the "pitting" variety, wherein the skin is slow to return to normal when pressed upon), raised jugular venous pressure and hepatomegaly , where the liver[en.wikipedia.org]

  • Cor Pulmonale

    liver, a loud pulmonic component of the 2nd heart sound, or evidence of venous thrombosis.[clinicaladvisor.com] , mild mitral regurgitation and mildly depressed left ventricular function with a shortening fraction of 24%.[casesjournal.biomedcentral.com] Hepatojugular reflux and pulsatile liver are signs of RV failure with systemic venous congestion. In severe disease, ascites can also be present.[emedicine.medscape.com]

  • Eisenmenger Syndrome

    […] tricuspid regurgitation in the setting of left to right shunt at the ventricular or atrial level Greater than mild tricuspid stenosis Intracavitary RV outflow obstruction[clinicaltrials.gov] A third heart sound as well as hepatosplenomegaly or a pulsatile liver occur with right heart failure. 4.2.[ncbi.nlm.nih.gov] Greater than mild mitral stenosis Intracavitary LV outflow obstruction Subvalvular or supravalvular aortic stenosis Aortic coarctation Greater than moderate mitral regurgitation[clinicaltrials.gov]

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