Doppler study of precordial musical murmurs

Pennestrì, Faustino; Boccardi, L; Minardi, Giovanni; Segni, M. Di; Pucci, Edoardo; Biasucci, Luigi M.; Ferrari, O; Lombardo, Antonella; Giovannini, E; Loperfido, Francesco

doi:10.1016/0002-9149(89)91054-0

Cited by 16 publications

(9 citation statements)

References 10 publications

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“…1,2 Other conditions associated with tiger stripes sign are any intracardiac oscillating mass and paraprosthetic leak. 3,4 Though the mechanism of its formation is still not clear, widely accepted mechanism is believed to be caused by fluttering of the disrupted cusp leading to the shedding of families of vortices in both a retrograde and an orthograde direction. The number of striations in the signal is likely to be related to the frequency of oscillation of the cusp and the presence or absence of mottling to the pattern of shedding of the vortices.…”

Section: Discussionmentioning

confidence: 99%

Tiger stripes sign

Jain

Krishnan

2015

Journal of Indian College of Cardiology

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a b s t r a c tTiger stripes sign (also known as Zebra stripes sign) is the high amplitude band-like signal noted on Doppler spectral recordings (pulsed and continuous both) of valvular regurgitation. This is noted most often in patients with porcine mitral prosthetic valves and may be indicative of flail prosthetic leaflet. Here we are reporting a case where tiger stripes sign was presenting in native mitral valve with mild mitral valve regurgitation.

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Section: Discussionmentioning

confidence: 99%

Tiger stripes sign

Jain

Krishnan

2015

Journal of Indian College of Cardiology

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“…Musical or ‘dove-coo’ murmurs are encountered during ultrasound of the brain supplying arteries [6]as well as during echocardiography [11, 12, 13, 14]. These murmurs are bidirectional signals in Doppler sonography mirrored at the baseline, which are characterized by a low basic sinusoidal frequency with superimposed harmonic qualities [6, 11, 12, 13, 14].…”

Section: Discussionmentioning

confidence: 99%

“…These murmurs are bidirectional signals in Doppler sonography mirrored at the baseline, which are characterized by a low basic sinusoidal frequency with superimposed harmonic qualities [6, 11, 12, 13, 14]. The exact mechanism of their generation in cerebrovascular ultrasound is still under debate [6].…”

Section: Discussionmentioning

confidence: 99%

“…In the cases of a recordable musical murmur in heart valve stenosis, cardiac ultrasound was unequivocally able to demonstrate the existence of vibrating poststenotic tissue [11, 12, 13, 14]. Miyahara et al [13] demonstrated in a tube model that any volatile membrane in the low-pressure area downstream to a severe stenosis could generate such a murmur due to a Venturi effect.…”

Section: Discussionmentioning

confidence: 99%

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The Venturi Effect and Cerebrovascular Ultrasound

Ritter

Ringelstein²

2002

Cerebrovasc Dis

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Background: One of the most frequent diagnostic pitfalls in cerebrovascular ultrasound is the evaluation of the vertebrobasilar system in the case of vertebral artery (VA) hypoplasia because the diagnostic findings are sometimes suggestive of significant pathologies, but may be completely normal as well. The Venturi effect is a phenomenon of hydrodynamics which describes a drop in hydrostatic pressure along areas of high flow velocities. Method: We review the physical background of the Venturi effect and describe how it can explain both physiological and pathological flow phenomena encountered during cerebrovascular ultrasound investigations. We focused on flow phenomena at the vertebrobasilar junction by theoretically calculating conditions with different influx angles and flow velocities on two-dimensional digital subtraction angiography images. In the discussion, we also address other areas of cerebrovascular ultrasound, where the Venturi effect is of particular interest. Results and Conclusions: The blood flow velocity within the VAs and the angle between a hypoplastic VA and the basilar artery (BA) are important determinants of the intraluminal pressures of these arteries and thus their resistances. In the case of angles below 90° between the distal VA and the BA, abnormal extracranial flow profiles may suggest downstream VA stenosis or occlusion, whereas in the case of angles above 90°, a diagnosis of an AV fistula downstream to the V4 segment may be assumed. Furthermore, various hemodynamic effects at the site of a stenosis of the brain supplying arteries can also be explained by a transstenotic pressure drop created by the Venturi effect, particularly the generation of musical murmurs. The systolic dip (‘systolic deceleration’) at the origin of the VA due to subclavian artery stenosis is also a consequence of the Venturi effect.

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“…MMs are usually described in the heart. They are seldom mentioned in connection with cerebrovascular disease [4,5]. We report the case of a man who presented with a headache that was caused by a cerebral arteriovenous malformation (cAVM).…”

Section: Introductionmentioning

confidence: 99%

The “seagull cry” in a patient with a cerebral arteriovenous malformation

Morelli

Rota

Michieletti

et al. 2012

Journal of Ultrasound

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KEYWORDSTranscranial Doppler sonography; Cerebral arteriovenous malformation; Murmurs.Abstract Introduction: The "seagull cry" is an acoustic phenomenon heard during duplex ultrasound. It is caused by harmonic covibrations of a vessel wall in the presence of highvelocity blood flow. It has been reported in a few cases of cerebrovascular disease, such as severe intracranial stenosis, vasospasm or carotid-cavernous fistula. Material and methods: A 35-year-old man underwent transcranial color-coded sonography (TCCS) for work-up of a severe new-onset headache. Results: Doppler spectral analysis of the right intracranial carotid bifurcation revealed multiple pairs of mirror-image parallel strings, and a high-frequency seagull cry was heard. Computed tomography-angiography and magnetic resonance imaging of the brain showed an arteriovenous malformation in the right temporal lobe. Discussion: The seagull cry is a "musical murmur" with single or multiple frequency that sounds like a musical tone. This is the first report of this phenomenon in a cerebral arteriovenous malformation.Sommario Introduzione: "Il pianto del gabbiano", fenomeno acustico eccezionale agli ultrasuoni che risulta della covibrazione armonica della parete dei vasi causata dall'incremento della velocità del sangue, è stato descritto raramente nella patologia cerebrovascolare. Materiali e metodi: Riportiamo il caso clinico di un giovane uomo sofferente di cefalea dovuta a una malformazione cerebrale arterovenosa (MAV) in cui "il pianto del gabbiano" è stato documentato all'eco-color-Doppler transcranico. Risultati: Il paziente fu sottoposto all'esame eco-color-Doppler transcranico. L'analisi spettrale della biforcazione carotidea intracranica destra mostrava la presenza di multiple stringhe parallele speculari ed era udibile un pianto del gabbiano ad alta frequenza. L'angio-TC e la risonanza magnetica dell'encefalo documentarono una MAV. Discussione: Il murmure musicale, noto anche come "pianto del gabbiano", è un murmure con frequenze single o multiple che risuona con un tono musicale. "Il pianto del gabbiano" in una MAV non è stato ancora descritto. ª

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Doppler study of precordial musical murmurs

Cited by 16 publications

References 10 publications

Tiger stripes sign

Tiger stripes sign

The Venturi Effect and Cerebrovascular Ultrasound

The “seagull cry” in a patient with a cerebral arteriovenous malformation

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