The most prevalent valvular disease in the industrialized world is aortic stenosis, which is characterized by a narrowing of the aortic valve. The stenosis is usually caused by senile calcification or a congenital abnormality like a bicuspid aortic valve (Thomas, 2021). Rheumatic heart illness can impact the aortic valve in a less common way. At the right upper sternal border, a crescendo-decrescendo systolic murmur can be heard, which can extend to the carotid arteries (Thomas, 2021). A build-up of calcium on the valve leaflets, low activity, lack of exercise, and an imbalanced diet are most likely the origin of aortic stenosis for TY.
The origin of the murmur can result from tricuspid regurgitation and stenosis. It is caused by bacterial vegetative growths, most typically found on the tricuspid valve, and connected with infective endocarditis (Thomas, 2021). It may also represent Tricuspid stenosis — a diastolic murmur detected around the sternal boundary on the lower left side. It is caused by infective endocarditis, which is common among intravenous drug users, and carcinoid syndrome (Thomas, 2021). Right atrial enlargement and arrhythmias may result from long-term tricuspid stenosis. In addition, it could be a mitral regurgitation is a systolic murmur that is best heard near the 5th midclavicular line on the left side, with probable propagation to the axilla (Thomas, 2021). Infective endocarditis, rheumatic heart disease, congenital abnormalities, and inferior wall myocardial infarctions are all prevalent causes. It is also possible to associate it with subvalvular aortic stenosis.
Subaortic stenosis, also known as subvalvular aortic stenosis (SAS), refers to the presence of a muscle membrane directly below the aortic valve. It produces a fixed barrier to blood flow through the left ventricular outflow tract (Mulla, 2021). Subvalvular aortic stenosis develops gradually, and patients seldom have distinct symptoms (Mulla, 2021). SAS can be associated with a ventricular septal defect, patent ductus arteriosus, aortic coarctation, bicuspid aortic valve, aberrant left ventricular papillary muscle, and/or an atrioventricular septal defect (Mulla, 2021). SAS is often discovered by chance in the majority of individuals while they are being evaluated for other cardiac problems.
References
Mulla, S. (2021).Subaortic stenosis. StatPearls.
Thomas, S. L. (2021).Physiology, cardiovascular murmurs.