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Reversed Rivero-Carvallo's sign in right-sided hypertrophic obstructive cardiomyopathy
Chest
|April 1, 1983
Insights
A unique case of hypertrophic obstructive cardiomyopathy in an 18-year-old presented with a reversed Rivero-Carvallo's sign. The systolic murmur intensity changed inversely with respiration, differing from typical presentations.
Area of Science:
- Cardiology
- Internal Medicine
- Clinical Case Study
Background:
- Hypertrophic obstructive cardiomyopathy (HOCM) is a significant cause of heart disease.
- The Rivero-Carvallo's sign, characterized by increased murmur intensity during inspiration, is a classic diagnostic finding in right ventricular pressure overload.
- Atypical presentations of HOCM can pose diagnostic challenges.
Observation:
- An 18-year-old male patient presented with symptoms suggestive of HOCM.
- A unique cardiovascular physical examination finding was noted: the systolic murmur intensity decreased during inspiration and increased during expiration.
- This observation is contrary to the typical Rivero-Carvallo's sign.
Findings:
- The patient was diagnosed with right-sided hypertrophic obstructive cardiomyopathy.
- The observed phenomenon represents a reversed Rivero-Carvallo's sign.
- This atypical respiratory variation in murmur intensity highlights a unique pathophysiological manifestation in HOCM.
Implications:
- This case underscores the importance of careful physical examination in diagnosing cardiovascular conditions.
- Understanding atypical signs like the reversed Rivero-Carvallo's sign can refine diagnostic accuracy for HOCM.
- Further research into the mechanisms behind such reversed signs may offer new insights into HOCM pathophysiology.
Abstract:
An 18-year-old patient had right-sided hypertrophic obstructive cardiomyopathy. His case was quite unique in that the intensity of the systolic murmur was apparently decreased during the inspiratory phase and increased during the expiratory phase (reversed Rivero-Carvallo's sign).