Means–Lerman scratch

The Means–Lerman scratch is an uncommon type of heart murmur which occurs in patients with hyperthyroidism. It is a mid-systolic scratching sound best heard over the upper part of the sternum or second left intercostal space at the end of expiration.[1] The murmur results from the rubbing of the pericardium against the pleura in the context of hyperdynamic circulation and tachycardia,[2] and may mimic the sound of a pericardial rub.[3]

The sign was described by J. Lerman M.D. and J. H. Means M.D. of Massachusetts General Hospital in 1932.[4]

References

  1. ^ Williams, Mark E (2007). "15. The Cardiovascular System". Geriatric physical diagnosis: a guide to observation and assessment (illustrated ed.). McFarland. p. 175. ISBN 978-0-7864-3009-3. 
  2. ^ Recognizing Thyroid Storm in the Neurologically Impaired Patient: Pathophysiology at Medscape
  3. ^ Fadel BM, Ellahham S, Ringel MD, Lindsay J, Wartofsky L, Burman KD (June 2000). "Hyperthyroid heart disease". Clin Cardiol 23 (6): 402–8. PMID 10875028. 
  4. ^ "Cardiovascular symptomatology in exophthalmic goiter". Am Heart J 8 (1): 55–65. October 1932. doi:10.1016/S0002-8703(32)90027-1. 
Stub icon This medical sign article is a stub. You can help Wikipedia by expanding it.
↑Jump back a section
Last modified on 10 May 2012, at 22:31