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Causes of thrill in different areas of pericardium

Definition of thrill
Thrill is defined as a palpable murmur that correlates with zones of maximum intensity of auscultated sounds.Thrill may be felt in mitral area, aortic area, pulmonary area or tricuspid area. The causes vary accordingly. Thrill may be either systolic or diastolic.
Thrill in mitral area
1.      Systolic thrill -the causes are
-             MR
-             VSD
-             ASD (ostium primum)
2.      Diastolic thrill
-             MS (commonest cause)
-             Left atrial myxoma rare cause
Thrill in aortic area
      Thrill in aortic area is commonly systolic
      It is due to a aortic stenosis
Thrill in pulmonary area
      Usually it is systolic
-             Pulmonary stenosis
-             Atrial septal defect
-             High ventricular septal defect
-             Fallot’s tetralogy
-             Patent  ductus arteriosus (continuous thrill)
Tricuspid area thrill
Usually systolic thrill, causes are
1.      Ventricular septal defect
2.      Tricuspid incompetence
3.      ASD (Ostium primum)
4.      Pulmonary stenosis (infundibular type)