Fourth Heart Sound

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Michael R. Jaff - One of the best experts on this subject based on the ideXlab platform.

  • adventitial fibromuscular dysplasia of the renal artery management challenges of nonatherosclerotic renal artery stenosis
    Circulation, 2009
    Co-Authors: Rory B Weiner, Thomas J. Kiernan, Bryan P Yan, Kenneth Rosenfield, Michael R. Jaff
    Abstract:

    A 19-year-old healthy woman presented with new onset of severe migrainous headache. She did not take medications or use illicit drugs. There was no personal or family history of hypertension. Physical examination revealed a blood pressure of 220/130 mm Hg in both arms. There was no Fourth Heart Sound. She had full and symmetric pulses in the upper and lower extremities with no radial/femoral delay. There were no carotid, subclavian, or abdominal bruits. Fundoscopic examination revealed normal retinal arteries without hypertensive retinopathy. Renal function and serum potassium were normal. Renal artery duplex ultrasonography revealed elevated peak systolic and end-diastolic velocities in the mid to distal portion of the right renal artery, consistent with severe right renal artery stenosis. The left renal artery was normal. The right kidney measured 8.8 cm with atrophy of the right cortical margin. The left kidney was 11.5 cm. There were normal renal resistive indexes …

  • Images in cardiovascular medicine. Adventitial fibromuscular dysplasia of the renal artery: management challenges of nonatherosclerotic renal artery stenosis.
    Circulation, 2009
    Co-Authors: Rory B Weiner, Thomas J. Kiernan, Bryan P Yan, Kenneth Rosenfield, Michael R. Jaff
    Abstract:

    A 19-year-old healthy woman presented with new onset of severe migrainous headache. She did not take medications or use illicit drugs. There was no personal or family history of hypertension. Physical examination revealed a blood pressure of 220/130 mm Hg in both arms. There was no Fourth Heart Sound. She had full and symmetric pulses in the upper and lower extremities with no radial/femoral delay. There were no carotid, subclavian, or abdominal bruits. Fundoscopic examination revealed normal retinal arteries without hypertensive retinopathy. Renal function and serum potassium were normal. Renal artery duplex ultrasonography revealed elevated peak systolic and end-diastolic velocities in the mid to distal portion of the right renal artery, consistent with severe right renal artery stenosis. The left renal artery was normal. The right kidney measured 8.8 cm with atrophy of the right cortical margin. The left kidney was 11.5 cm. There were normal renal resistive indexes …

Rory B Weiner - One of the best experts on this subject based on the ideXlab platform.

  • Adventitial Fibromuscular Dysplasia of the Renal Artery Management Challenges of Nonatherosclerotic Renal Artery Stenosis
    2016
    Co-Authors: Rory B Weiner, Kenneth Rosenfield, Md Thomas, J. Kiernan, Md Bryan, P. Yan, Md Michael, R. Jaff
    Abstract:

    A 19-year-old healthy woman presented with new onsetof severe migrainous headache. She did not take medi-cations or use illicit drugs. There was no personal or family history of hypertension. Physical examination revealed a blood pressure of 220/130 mm Hg in both arms. There was no Fourth Heart Sound. She had full and symmetric pulses in the upper and lower extremities with no radial/femoral delay. There were no carotid, subclavian, or abdominal bruits. Fundoscopic examination revealed normal retinal arteries without hypertensive retinopathy. Renal function and serum potassium were normal. Renal artery duplex ultrasonography revealed elevated peak systolic and end-diastolic velocities in the mid to distal portion of the right renal artery, consistent with severe right renal artery stenosis. The left renal artery was normal. The right kidney measured 8.8 cm with atrophy of the right cortical margin. The left kidney was 11.5 cm

  • adventitial fibromuscular dysplasia of the renal artery management challenges of nonatherosclerotic renal artery stenosis
    Circulation, 2009
    Co-Authors: Rory B Weiner, Thomas J. Kiernan, Bryan P Yan, Kenneth Rosenfield, Michael R. Jaff
    Abstract:

    A 19-year-old healthy woman presented with new onset of severe migrainous headache. She did not take medications or use illicit drugs. There was no personal or family history of hypertension. Physical examination revealed a blood pressure of 220/130 mm Hg in both arms. There was no Fourth Heart Sound. She had full and symmetric pulses in the upper and lower extremities with no radial/femoral delay. There were no carotid, subclavian, or abdominal bruits. Fundoscopic examination revealed normal retinal arteries without hypertensive retinopathy. Renal function and serum potassium were normal. Renal artery duplex ultrasonography revealed elevated peak systolic and end-diastolic velocities in the mid to distal portion of the right renal artery, consistent with severe right renal artery stenosis. The left renal artery was normal. The right kidney measured 8.8 cm with atrophy of the right cortical margin. The left kidney was 11.5 cm. There were normal renal resistive indexes …

  • Images in cardiovascular medicine. Adventitial fibromuscular dysplasia of the renal artery: management challenges of nonatherosclerotic renal artery stenosis.
    Circulation, 2009
    Co-Authors: Rory B Weiner, Thomas J. Kiernan, Bryan P Yan, Kenneth Rosenfield, Michael R. Jaff
    Abstract:

    A 19-year-old healthy woman presented with new onset of severe migrainous headache. She did not take medications or use illicit drugs. There was no personal or family history of hypertension. Physical examination revealed a blood pressure of 220/130 mm Hg in both arms. There was no Fourth Heart Sound. She had full and symmetric pulses in the upper and lower extremities with no radial/femoral delay. There were no carotid, subclavian, or abdominal bruits. Fundoscopic examination revealed normal retinal arteries without hypertensive retinopathy. Renal function and serum potassium were normal. Renal artery duplex ultrasonography revealed elevated peak systolic and end-diastolic velocities in the mid to distal portion of the right renal artery, consistent with severe right renal artery stenosis. The left renal artery was normal. The right kidney measured 8.8 cm with atrophy of the right cortical margin. The left kidney was 11.5 cm. There were normal renal resistive indexes …

Sándor J. Kovács - One of the best experts on this subject based on the ideXlab platform.

  • Relationship of the Fourth Heart Sound to atrial systolic transmitral flow deceleration.
    American Journal of Physiology-Heart and Circulatory Physiology, 1997
    Co-Authors: Abigail Manson Mcguire, M. T. Hagley, A.f. Hall, Sándor J. Kovács
    Abstract:

    The Fourth Heart Sound (S4) is thought to be due to cardiohemic vibrations, powered by deceleration of transmitral blood flow, that occur when atrial systole leads to a disproportionately high rise...

  • Relationship of the Fourth Heart Sound to atrial systolic transmitral flow deceleration.
    The American journal of physiology, 1997
    Co-Authors: Abigail Manson Mcguire, M. T. Hagley, A.f. Hall, Sándor J. Kovács
    Abstract:

    The Fourth Heart Sound (S4) is thought to be due to cardiohemic vibrations, powered by deceleration of transmitral blood flow, that occur when atrial systole leads to a disproportionately high rise in ventricular end-diastolic pressure (relative to diastasis), associated with an enhanced atrial systolic blood filling volume or a stiff ventricular wall. To characterize S4 production, we modeled the cardiohemic system as a forced, damped nonlinear harmonic oscillator. The forcing term used a closed-form expression for the Doppler A-wave contour. We simultaneously recorded transthoracic phonocardiograms and Doppler A waves in subjects with and without audible S4 and compared model predictions for S4 amplitude, frequency, and power spectrum with those of the recorded S4. Excellent agreement was observed between the model-predicted amplitude, duration, timing, and power spectrum and those of the phonocardiographic S4. We conclude that, with a normal mitral valve, there should always be an oscillation of the cardiohemic system during A-wave deceleration. However, oscillations may not have high enough amplitude, frequency, or coupling to the chest wall to be clinically audible as an S4.

Kenneth Rosenfield - One of the best experts on this subject based on the ideXlab platform.

  • Adventitial Fibromuscular Dysplasia of the Renal Artery Management Challenges of Nonatherosclerotic Renal Artery Stenosis
    2016
    Co-Authors: Rory B Weiner, Kenneth Rosenfield, Md Thomas, J. Kiernan, Md Bryan, P. Yan, Md Michael, R. Jaff
    Abstract:

    A 19-year-old healthy woman presented with new onsetof severe migrainous headache. She did not take medi-cations or use illicit drugs. There was no personal or family history of hypertension. Physical examination revealed a blood pressure of 220/130 mm Hg in both arms. There was no Fourth Heart Sound. She had full and symmetric pulses in the upper and lower extremities with no radial/femoral delay. There were no carotid, subclavian, or abdominal bruits. Fundoscopic examination revealed normal retinal arteries without hypertensive retinopathy. Renal function and serum potassium were normal. Renal artery duplex ultrasonography revealed elevated peak systolic and end-diastolic velocities in the mid to distal portion of the right renal artery, consistent with severe right renal artery stenosis. The left renal artery was normal. The right kidney measured 8.8 cm with atrophy of the right cortical margin. The left kidney was 11.5 cm

  • adventitial fibromuscular dysplasia of the renal artery management challenges of nonatherosclerotic renal artery stenosis
    Circulation, 2009
    Co-Authors: Rory B Weiner, Thomas J. Kiernan, Bryan P Yan, Kenneth Rosenfield, Michael R. Jaff
    Abstract:

    A 19-year-old healthy woman presented with new onset of severe migrainous headache. She did not take medications or use illicit drugs. There was no personal or family history of hypertension. Physical examination revealed a blood pressure of 220/130 mm Hg in both arms. There was no Fourth Heart Sound. She had full and symmetric pulses in the upper and lower extremities with no radial/femoral delay. There were no carotid, subclavian, or abdominal bruits. Fundoscopic examination revealed normal retinal arteries without hypertensive retinopathy. Renal function and serum potassium were normal. Renal artery duplex ultrasonography revealed elevated peak systolic and end-diastolic velocities in the mid to distal portion of the right renal artery, consistent with severe right renal artery stenosis. The left renal artery was normal. The right kidney measured 8.8 cm with atrophy of the right cortical margin. The left kidney was 11.5 cm. There were normal renal resistive indexes …

  • Images in cardiovascular medicine. Adventitial fibromuscular dysplasia of the renal artery: management challenges of nonatherosclerotic renal artery stenosis.
    Circulation, 2009
    Co-Authors: Rory B Weiner, Thomas J. Kiernan, Bryan P Yan, Kenneth Rosenfield, Michael R. Jaff
    Abstract:

    A 19-year-old healthy woman presented with new onset of severe migrainous headache. She did not take medications or use illicit drugs. There was no personal or family history of hypertension. Physical examination revealed a blood pressure of 220/130 mm Hg in both arms. There was no Fourth Heart Sound. She had full and symmetric pulses in the upper and lower extremities with no radial/femoral delay. There were no carotid, subclavian, or abdominal bruits. Fundoscopic examination revealed normal retinal arteries without hypertensive retinopathy. Renal function and serum potassium were normal. Renal artery duplex ultrasonography revealed elevated peak systolic and end-diastolic velocities in the mid to distal portion of the right renal artery, consistent with severe right renal artery stenosis. The left renal artery was normal. The right kidney measured 8.8 cm with atrophy of the right cortical margin. The left kidney was 11.5 cm. There were normal renal resistive indexes …

Bryan P Yan - One of the best experts on this subject based on the ideXlab platform.

  • adventitial fibromuscular dysplasia of the renal artery management challenges of nonatherosclerotic renal artery stenosis
    Circulation, 2009
    Co-Authors: Rory B Weiner, Thomas J. Kiernan, Bryan P Yan, Kenneth Rosenfield, Michael R. Jaff
    Abstract:

    A 19-year-old healthy woman presented with new onset of severe migrainous headache. She did not take medications or use illicit drugs. There was no personal or family history of hypertension. Physical examination revealed a blood pressure of 220/130 mm Hg in both arms. There was no Fourth Heart Sound. She had full and symmetric pulses in the upper and lower extremities with no radial/femoral delay. There were no carotid, subclavian, or abdominal bruits. Fundoscopic examination revealed normal retinal arteries without hypertensive retinopathy. Renal function and serum potassium were normal. Renal artery duplex ultrasonography revealed elevated peak systolic and end-diastolic velocities in the mid to distal portion of the right renal artery, consistent with severe right renal artery stenosis. The left renal artery was normal. The right kidney measured 8.8 cm with atrophy of the right cortical margin. The left kidney was 11.5 cm. There were normal renal resistive indexes …

  • Images in cardiovascular medicine. Adventitial fibromuscular dysplasia of the renal artery: management challenges of nonatherosclerotic renal artery stenosis.
    Circulation, 2009
    Co-Authors: Rory B Weiner, Thomas J. Kiernan, Bryan P Yan, Kenneth Rosenfield, Michael R. Jaff
    Abstract:

    A 19-year-old healthy woman presented with new onset of severe migrainous headache. She did not take medications or use illicit drugs. There was no personal or family history of hypertension. Physical examination revealed a blood pressure of 220/130 mm Hg in both arms. There was no Fourth Heart Sound. She had full and symmetric pulses in the upper and lower extremities with no radial/femoral delay. There were no carotid, subclavian, or abdominal bruits. Fundoscopic examination revealed normal retinal arteries without hypertensive retinopathy. Renal function and serum potassium were normal. Renal artery duplex ultrasonography revealed elevated peak systolic and end-diastolic velocities in the mid to distal portion of the right renal artery, consistent with severe right renal artery stenosis. The left renal artery was normal. The right kidney measured 8.8 cm with atrophy of the right cortical margin. The left kidney was 11.5 cm. There were normal renal resistive indexes …