|
|
| Author |
Message |
lndkrn
Joined: 07 Mar 2005
Posts: 2
posting in usmle forum about USMLE Step 2 CK
|
 Posted : Tue Mar 22, 2005 Post subject: Hypertrophic Cardiomyopathy and Valsalva Maneuver |
 |
|
does anyone know WHY preload reduction (eg. valsalva maneuver) and afterload reduction (eg. NTG and other vasodilators) would increase obstruction (thereby making the murmur louder) in HCM???  |
|
| Back to top |
|
 |
Dharam
Joined: 07 Mar 2005
Posts: 2
posting in usmle forum about USMLE Step 2 CK
|
Posted : Wed Apr 06, 2005 Post subject: HCM murmur.. by dharm |
|
|
yes... as you decrease the preload, less blood will be going to the hypertrophic heart... now use ur imagination.. the heart chamber already is congested... so low volume in it will cause more congestion. so lower the preload more the congestion greater the murmur..
same principle applies. youdecrease the afterload, less SVR more blood will be out of the heart.. and less will stay back in left vent. and more the congestion will occur. instead of keeping blood in it and keeping ventricle distended . |
|
| Back to top |
|
|
rony
Guest
posting in usmle forum about USMLE Step 2 CK
|
Posted : Mon May 02, 2005 Post subject: Re: HCM murmur.. by dharm |
|
|
| Dharam wrote: | yes... as you decrease the preload, less blood will be going to the hypertrophic heart... now use ur imagination.. the heart chamber already is congested... so low volume in it will cause more congestion. so lower the preload more the congestion greater the murmur..
same principle applies. youdecrease the afterload, less SVR more blood will be out of the heart.. and less will stay back in left vent. and more the congestion will occur. instead of keeping blood in it and keeping ventricle distended . |
the smaller the chamber size the more obstuction to outflow and the louder murmur is the result.so decrese in preload or decrese in after load will result in increase in murmur[/b] |
|
| Back to top |
|
|
|
FAQ
Search
Memberlist
Usergroups
Log in
