Carey Coombs murmur
Encyclopedia
The Carey Coombs murmur or Coombs murmur is a clinical sign
which occurs in patients with mitral valvulitis due to acute rheumatic fever
. It is described as a short, mid-diastolic rumble best heard at the apex
, which disappears as the valvulitis improves. It is often associated with an S3
gallop rhythm
, and can be distinguished from the diastolic murmur of mitral stenosis
by the absence of an opening snap before the murmur. The murmur is caused by increased blood flow across a thickened mitral valve
.
The sign is named after Carey Coombs
.
Medical sign
A medical sign is an objective indication of some medical fact or characteristic that may be detected by a physician during a physical examination of a patient....
which occurs in patients with mitral valvulitis due to acute rheumatic fever
Rheumatic fever
Rheumatic fever is an inflammatory disease that occurs following a Streptococcus pyogenes infection, such as strep throat or scarlet fever. Believed to be caused by antibody cross-reactivity that can involve the heart, joints, skin, and brain, the illness typically develops two to three weeks after...
. It is described as a short, mid-diastolic rumble best heard at the apex
Apex of the heart
The apex of the heart is the lowest superficial part of the heart.It is directed downward, forward, and to the left, and is overlapped by the left lung and pleura.-External anatomy:...
, which disappears as the valvulitis improves. It is often associated with an S3
Third heart sound
The third heart sound or S3 is a rare extra heart sound that occurs soon after the normal two "lub-dub" heart sounds .-Physiology:It occurs at the beginning of diastole approximately 0.12 to 0.18 seconds after S2...
gallop rhythm
Gallop rhythm
A gallop rhythm refers to a rhythm of the heart on auscultation. It includes three or four sounds, thus resembling the sounds of a gallop....
, and can be distinguished from the diastolic murmur of mitral stenosis
Mitral stenosis
Mitral stenosis is a valvular heart disease characterized by the narrowing of the orifice of the mitral valve of the heart.-Signs and symptoms:Symptoms of mitral stenosis include:...
by the absence of an opening snap before the murmur. The murmur is caused by increased blood flow across a thickened mitral valve
Mitral valve
The mitral valve is a dual-flap valve in the heart that lies between the left atrium and the left ventricle...
.
The sign is named after Carey Coombs
Carey Coombs
Carey Franklin Coombs was a British cardiologist.He was awarded his M.B. in 1901, M.D. in 1903 and made a Fellow of the Royal College of Physicians in 1917. He became Physician at Bristol General Hospital in 1920 and Director of the Bristol University Centre of Cardiac Research in 1927...
.