Graham Steell murmur

Graham Steell murmur
Differential diagnosispulmonary regurgitation

A Graham Steell murmur is a heart murmur typically associated with pulmonary regurgitation.[1][2] It is a high pitched early diastolic murmur heard best at the left sternal edge in the second intercostal space with the patient in full inspiration, originally described in 1888.

The murmur is heard due to a high velocity flow back across the pulmonary valve; this is usually a consequence of pulmonary hypertension secondary to mitral valve stenosis. The Graham Steell murmur is often heard in patients with chronic cor pulmonale (pulmonary heart disease) as a result of chronic obstructive pulmonary disease.

In cases of mitral obstruction the murmur is occasionally heard over the pulmonary area and below this region, for the distance of an inch or two along the left border of the sternum.[3] It's also rarely over the lowest part of the bone itself, a soft blowing diastolic murmur immediately following P2.[3]

It is named after Graham Steell.[4]

References

  1. ↑ Archives of Diagnosis, Volume 10. University of Chicago. 1918. p. 60. Retrieved 27 October 2017.
  2. ↑ Heart sounds made incredibly easy!. Ambler, Pa.: Lippincott Williams & Wilkins. 2005. p. 143. ISBN 9781582553580.
  3. 1 2 Jose, V. Jacob (2017). Cardiology: Clinical Methods. JP Medical Ltd. p. 82. ISBN 9789385999451.
  4. ↑ Fraser, Alan G.; Weston, Clive F. M. (January 1991). "The Graham Steell Murmur: Eponymous Serendipity?". J R Coll Physicians Lond. 25 (1): 66–70. PMC 5377079. PMID 2023159.


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