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THE GRAHAM STEELL MURMUR

1928; American Medical Association; Volume: 90; Issue: 8 Linguagem: Inglês

10.1001/jama.1928.02690350021009

2376-8118

Paul D. White,

Phonocardiography and Auscultation Techniques

The rarity of the Graham Steell murmur and especially the rarity of its confirmation by postmortem examination, together with the confused ideas as to its occurrence and significance in the minds of most physicians, show the need of such a case report as that which follows. The Graham Steell murmur 1 is the early blowing diastolic murmur heard along the left border of the sternum due to functional regurgitation through the pulmonic valve. The pulmonic valve itself is not diseased; its ring of attachment is stretched as a result of chronic pulmonary hypertension from marked mitral stenosis. The pulmonic artery is dilated. At postmortem examination the valve ring may not be widely dilated, the leak being largely the result of hydrodynamic effects during life. Generally, when the Graham Steell murmur has been diagnosed during life, aortic regurgitation has been found post mortem, explaining the supposed pulmonic regurgitant murmur. Thus it