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Related Experiment Videos

Variable diastolic rumbling murmur caused by floating left atrial thrombus.

C C Chen, M C Hsiung, B N Chiang

    British Heart Journal
    |August 1, 1983
    PubMed
    Summary

    A floating left atrial thrombus caused recurrent fainting spells in a patient with mitral stenosis. The thrombus intermittently obstructing the mitral valve explained the variable murmur and syncope.

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    Area of Science:

    • Cardiology
    • Medical Diagnostics
    • Cardiac Physiology

    Background:

    • Rheumatic heart disease can lead to mitral stenosis, a narrowing of the mitral valve.
    • Recurrent syncope (fainting spells) can be a symptom of severe cardiac conditions.
    • Left atrial thrombus formation is a known complication in patients with mitral valve disease.

    Observation:

    • A 53-year-old male patient presented with recurrent syncope.
    • Physical examination revealed a variable diastolic rumbling murmur.
    • Echocardiography and phonocardiography were performed simultaneously.

    Findings:

    • A mobile left atrial thrombus was visualized.
    • The thrombus intermittently prolapsed into the mitral valve orifice.
    • Mitral valve obstruction by the thrombus correlated with the disappearance of the diastolic murmur.

    Implications:

    • This case highlights the dynamic nature of thrombus-induced mitral valve obstruction.
    • It underscores the importance of correlating clinical findings with diagnostic imaging in complex cardiac cases.
    • Understanding this mechanism can aid in the diagnosis and management of syncope in patients with valvular heart disease.

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