From the Research
The Gallavardin phenomenon in aortic stenosis is caused by the vibration of calcified aortic valve leaflets at different frequencies, resulting in a split systolic murmur with a low-pitched component at the base and a high-pitched component at the apex. This phenomenon occurs due to the turbulent flow of blood through the narrowed aortic valve opening, creating vibrations in the stiffened, calcified valve leaflets. The lower frequency vibrations produce the typical harsh murmur heard at the base of the heart, while higher frequency vibrations travel to the apex, mimicking mitral regurgitation. Key characteristics of the Gallavardin phenomenon include:
- A split systolic murmur with two distinct components
- A low-pitched component heard best at the right upper sternal border
- A high-pitched musical component that radiates to the apex and left axilla
- Occurs in moderate to severe aortic stenosis with significant calcification of the valve leaflets
- Typically seen in older patients with degenerative aortic stenosis The Gallavardin phenomenon is clinically significant because the apical component can be mistaken for mitral regurgitation, potentially leading to diagnostic confusion 1. In clinical practice, it is essential to consider the Gallavardin phenomenon when evaluating patients with aortic stenosis to avoid misdiagnosis and ensure appropriate management. The phenomenon's implications on patient outcomes and treatment strategies are crucial, particularly in the context of transcatheter valve replacement and surgical aortic valve replacement 2, 3. However, the provided studies do not directly address the Gallavardin phenomenon, and the information is based on general knowledge of aortic stenosis and valve disease 4, 5. The most recent and highest-quality study on valve disease, although not directly related to the Gallavardin phenomenon, highlights the importance of considering the combined hemodynamic impact of valve lesions and the potential benefits of earlier intervention in high-risk patients 1.