Related Experiment Video

Updated: Apr 27, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
07:41

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

3.7K

Ventriculo-arterial coupling in children with Still's murmur

Juliane Engel1, Sigrid Baumgartner2, Silvia Novak1

  • 1Division of Pediatric Cardiology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.

Physiological Reports
|July 5, 2014
PubMed

Insights

Still's murmur, a common innocent heart murmur in children, may stem from subtle changes in ventriculo-arterial coupling (VAC). This "lively interplay" between the heart and aorta explains the murmur in healthy children.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Physiology
  • Echocardiography

Background:

  • Still's murmur is the most frequent innocent heart murmur in children, often attributed to blood flow but lacking a definitive explanation.
  • Understanding the underlying mechanisms of Still's murmur is crucial for accurate diagnosis and parental reassurance.

Purpose of the Study:

  • To investigate the hemodynamic ventriculo-arterial interaction in children with and without Still's murmur.
  • To assess the proportional anatomical dimensions of the left ventricle and aortic root in relation to cardiac function.

Main Methods:

  • A case-control study involving healthy children with (n=43) and without (n=42) Still's murmur.
  • Application of the ventriculo-arterial coupling (VAC) model, utilizing M-mode echocardiography to derive parameters like effective arterial elastance (EA) and left ventricular contractility (ELV).
  • Analysis included VAC ratio (EA/ELV), ejection fraction (EF), stroke volume (SV), blood pressure (BP), heart rate (HR), and cardiac dimensions.

Main Results:

  • Children with Still's murmur exhibited a significantly lower VAC ratio (EA/ELV) compared to controls (P < 0.005).
  • Higher ejection fraction (EF%) and greater stroke volume (SV) per kg bodyweight were observed in children with Still's murmur (P < 0.005, P < 0.05).
  • No significant differences were found in blood pressure, heart rate, or aortic root and left ventricular dimensions between the groups.

Conclusions:

  • Still's murmur in healthy children appears to be associated with subtle alterations in ventriculo-arterial coupling.
  • The findings suggest a 'lively interplay' between the heart and aorta as the likely cause of this common innocent murmur.
  • This understanding can help reassure parents about the benign nature of Still's murmur.

Keywords:
ChildrenStill's murmurechocardiographyventriculo‐arterial coupling

More Related Videos

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography09:31

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography

Published on: January 27, 2023

2.0K
Author Spotlight: Establishment and Confirmation of a Postnatal Right Ventricular Volume Overload Mouse Model06:04

Author Spotlight: Establishment and Confirmation of a Postnatal Right Ventricular Volume Overload Mouse Model

Published on: June 9, 2023

1.6K

Related Concept Videos

Cardiovascular System Abnormal Findings II: Auscultation01:25

Cardiovascular System Abnormal Findings II: Auscultation

Auscultation, an essential part of a heart examination, is done using a stethoscope. It provides crucial information about heart function and possible heart problems. Due to heart problems, abnormal sounds can be heard during systole or diastole. These sounds include S3 and S4 gallops, opening snaps, systolic clicks, and murmurs.
Abnormal Heart Sounds
Gallops:
847
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
1.3K
Heart Sounds01:15

Heart Sounds

Heart sounds are generated by the turbulence in blood flow due to the closing of heart valves. These sounds are best perceived slightly away from the valves, where the blood flow disseminates the sound.
Auscultation is the process of listening to these internal body sounds using a stethoscope. The heart produces four types of sounds, but only two—S1 and S2—can usually be heard with a stethoscope.
S1, also known as the "lub" sound, is caused by the closure of atrioventricular (A-V)...
3.6K
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
1.8K
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
1.6K
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
550