Diastolic Dysfunction

Diastolic murmurs are graded on a scale of 1 to 4, while systolic murmurs are graded on a scale of 1 to 6.

Diastolic mitral regurgitation can occur in the setting of complete heart block when the atrium contracts early after ventricular contraction resulting in a prolonged left ventricular filling period increasing LV pressure toward end-diastole despite a lower left atrial pressure.

The hypertrophic cardiomyopathies include several diseases with different etiologies, all of which are characterized by abnormal thickening of the myocardium, most commonly in the interventricular septum.

Diastolic dysfunction occurs when the left ventricular myocardium is non-compliant and not able to accept blood return in a normal fashion from the left atrium.

Dock’s murmur occurs when there is a severe stenosis of the left anterior descending coronary artery. The murmur produced is diastolic since the coronary arteries fill in diastole.

The Bernheim effect describes right heart failure developing prior to left heart failure in patients with aortic stenosis due to the hypertrophied ventricular septum bulging into the right ventricle impairing right ventricular diastolic function.