Disease of the Semi lunar Valves.
THE inflammation of the lining of the heart makes sad work with the valves. The semi lunars are subject to various changes in their structure.
Physical Signs. Obstructive Murmur. In disease of the semi lunars, the first beat of the heart is accompanied or obscured either by the bellows murmur, or a,, awing, rasping, or filing sound. The unnatural murmur, whatever it is, appears superficial or near. The second beat is natural.
When the opening into the aorta is contracted, or in any way obstructed by unhealthy growths, so that the blood is subjected to more than a natural degree of friction in passing, this sound will be heard. It is called obstructive, because it arises from the obstruction of the blood in its forward course.
Regurgitant Murmurs. First beat of heart natural. Second beat accompanied or replaced by bellows murmur. There is sometimes a musical murmur.
Explanation. The regurgitant murmurs arise from the valves being too small, or defective in some way, and allowing the blood to flow back through the orifice.
This murmur is loudest opposite the semi lunar valves, and is more audible above these valves than below them.
When the aortic valves are contracted or shortened, and the openings are not guarded by them, so as to prevent the backward passage of the blood, there is a double bellows murmur, one when it is driven through the orifice, and another when it flows back.
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