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Comments, Opinions, and Brief Case Reports
March 11, 2002

Bruxism Masquerading as a Murmur

Arch Intern Med. 2002;162(5):606. doi:

Bruxism, or involuntary teeth grinding, may lead to premature wearing of the teeth and temporomandibular damage.1 Reported herein is the case of an elderly woman whose bruxism created a high-pitched, biphasic squeaking sound that was detected upon cardiac auscultation, which disappeared when the patient opened her mouth.

A 90-year-old woman with Alzheimer dementia was admitted to the hospital after falling and sustaining an intertrochanteric hip fracture. A preoperative medical consultation was requested. Cardiac auscultation revealed a biphasic, high-pitched, squeaking sound heard maximally over the cardiac apex, as well as the upper and lower sternal borders and the clavicles. During repeated auscultation, the sound persisted and the patient was noted to be grinding her teeth; when asked to open her mouth, the sound ceased. The patient was repeatedly observed and manifested intermittent bruxism. The patient was taken to surgery without incident.

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