Austin Flint murmur

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In cardiology, an Austin Flint murmur is a mid-diastolic[citation needed] or presystolic murmur[1] low-pitched rumbling murmur which is best heard at the cardiac apex.[2] It is associated with severe aortic regurgitation, although the role of this sign in clinical practice has been questioned.[3]

Mechanism

Echocardiography, conventional and colour flow doppler ultrasound, and cine nuclear magnetic resonance (cine NMR) imaging suggest the murmur is the result of (aortic regurgitant) flow impingement on the inner surface of the heart, i.e. the endocardium.[4][5]

Classical description

Classically, it is described as being the result of mitral valve leaftlet displacement and turbulent mixing of antegrade mitral flow and retrograde aortic flow:[6]

Displacement: The blood jets from the aortic regurgitation strike the anterior leaflet of the mitral valve, which often results in premature closure of the mitral leaflets. This can be mistaken for mitral stenosis.

Turbulence of the two columns of blood: Blood from left atrium to left ventricle and blood from aorta to left ventricle.

Treatment

Aortic valve replacement may be necessary to correct the abnormality if symptomatic.

Name

The Austin Flint murmur is named after the 19th century American physician Austin Flint (1812–1886).[7][8]

References

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  1. Austin Flint murmur at Dorland's Medical Dictionary
  2. Flint A (1862). "On cardiac murmurs". American Journal of the Medical Sciences. 44: 29–54. 
  3. Babu AN, Kymes SM, Carpenter Fryer SM (2003). "Eponyms and the diagnosis of aortic regurgitation: what says the evidence?". Annals of Internal Medicine. 138 (9): 736–742. PMID 12729428. 
  4. Landzberg JS, Pflugfelder PW, Cassidy MM, Schiller NB, Higgins CB, Cheitlin MD (1992). "Etiology of the Austin Flint murmur". Journal of the American College of Cardiology. 20 (2): 408–413. doi:10.1016/0735-1097(92)90110-9. PMID 1634679. 
  5. Weir RA, Dargie HJ (2008). "Austin Flint Murmur". New England Journal of Medicine. 359 (10): e11. doi:10.1056/NEJMicm072437. PMID 18768939. 
  6. Austin Flint murmur at GPnotebook Accessed on: June 4, 2007.
  7. Flint's murmur or symptom at Who Named It?
  8. Austin Flint at Who Named It?