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Systolic honk in heart failure: its origin and mechanism of production
Insights
Systolic honks, typically linked to mitral valve prolapse, can also occur with tricuspid valve issues. Echocardiograms revealed tricuspid valve fluttering during honks in heart failure patients.
Area of Science:
- Cardiology
- Cardiac Auscultation
- Echocardiography
Background:
- Systolic honks are traditionally associated with mitral valve prolapse.
- Congestive heart failure can lead to complex cardiac valve dynamics.
Observation:
- Two cases presented with systolic honks during worsening congestive heart failure.
- Simultaneous echocardiography and phonocardiography were performed.
Findings:
- Fluttering of the tricuspid valve was observed during the systolic honk.
- This tricuspid valve fluttering correlated directly with the presence of the honk.
- Tricuspid valve fluttering was absent when the honk was not present.
Implications:
- Suggests tricuspid valve involvement as a potential cause of systolic honks.
- Highlights the utility of echocardiography in diagnosing the origin of cardiac sounds.
- May refine understanding of systolic honk mechanisms in heart failure.
Abstract:
Systolic honks have so far been synonymous with prolapse of the mitral valve leaflet. Evidence of tricuspid valve involvement in two cases is presented. These patients developed systolic honk during the deterioration of their congestive heart failure. Simultaneous recordings of echocardiograms and phonocardiograms showed fluttering of the tricuspid valve, coinciding with the systolic honk. This fluttering was not seen when honk was absent. The mechanism of production of this honk is discussed.