Coombs Heart Noise

**Heart murmur** is a pathological condition in which a suddenly increasing, loud, unstable, relatively musical murmur, detected at a distance from the heart, is heard above the apex of the heart. At the same time, the heart contracts rhythmically. The symptom is not a separate disease, but can occur with various pathologies of the cardiovascular system and appear during physical activity, stress, or after an illness.

The first mention of this sign in the 19th century was made by William Coombes, who identified heart murmur due to the need to differentiate it from gastric murmur. Then R. Goldmark (R Goldmark, 1956) identified various types of murmurs and proposed the following classification: - protodiastolic or mesodiastolic murmur; - presystolic murmur.

In 1960, R Goldmark proposed a classification based on noise wave analysis:

Murmurs caused by the movement of the valve leaflets or their parietal regurgitation are called high-frequency. These murmurs are heard in systole in a limited area of ​​the chambers of the heart or in diastole over the entire area of ​​the heart without clear localization. They are usually high-frequency, loud, with a jagged-bell or blowing component.

For a deeper understanding of heart murmur, it is necessary to know the structure and anatomy of the heart chamber (the heart chamber is a cavity formed by 2 adjacent chamber valves). Secondary to the own layers of the chamber wall becomes the fibrobronchial pericardium, consisting of three layers of fibrous tissue - the epicardium (outside), the myocardium