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Inconstancy is much more frequently a characteristic of regurgitant murmurs at the auriculo-ventricular orifices of the heart than of any other cardiac murmurs. We propose to study the reasons for this inconstancy, particularly as affecting the mitral valve, although much that we say applies equally well to the tricuspid. We shall first look briefly into the character and mode of production of the other murmurs. At the arterial orifices we may have direct murmurs from anemia, or infinitely less often, from obstruction in some form; and regurgitant ones from a, damage to the leaflets of the valves, or b, stretching of the ring supporting them. All of these are practically constant excepting the direct ones of anemic origin, which disappear under the use of iron in many cases.
Presystolic murmurs originate from narrowing of the auriculo-ventricular orifices, and are, practically, constant, excepting that weakening of the auricular wall may lower
HALL JN. THE CAUSES OF THE INCONSTANCY OF MITRAL REGURGITANT MURMURS. JAMA. 1898;XXXI(4):175–176. doi:10.1001/jama.1898.92450040025001d
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