Late diastolic gallop
Introduction
Introduction The late 1st diastolic gallop occurs late, before the onset of systole, which is 0.1s before the first heart sound, so it is also called presystolic gallop. The mechanism of its production is increased left ventricular pressure and decreased compliance at the end of diastole. The left atrium is caused by increased contraction to overcome the increased ventricular filling resistance, and is therefore also called atrial gallop. Late diastolic galloping from the right atrium is rare.
Cause
Cause
Mainly due to increased ventricular filling and decreased myocardial compliance, resulting in increased ventricular end-diastolic pressure, resulting in enhanced atrial contractility. It is also known as atrial gallop. In fact, it is a fourth heart sound or a pathological fourth heart sound. It reflects cardiac hypertrophy and structural abnormalities (such as myocardial sclerosis, scarring, fibrosis, etc.).
Examine
an examination
Related inspection
Arterial auscultation chest B-ultrasound
Auscultation features:
1 tone is lower.
2 intensity is weak.
3 The extra heart sound is farther away from S2 and is closer to S1.
4 The clearest part of the auscultation is slightly inside the apical area (for example, from the right atrium, between the 3 and 4 ribs on the left sternal border).
5 Auscultation is most obvious when lying on the left side, and can be reduced or disappeared when sitting or standing.
6 The end of exhalation is the loudest (if from the right atrium, it is strengthened at the end of inspiration).
Diagnosis
Differential diagnosis
Differential diagnosis of diastolic late galloping:
The first heart sound splits: the two components of the first heart sound split have substantially the same sound properties, while the extra heart sounds of the galloping horse before the systolic period are more blunt and easier to hear when the heart beats.
