Carvallo sign
Carvallo sign
Carvallo sign is a clinical sign found in patients with
A. Mitral stenosis
B. Mitral regurgitation
C. Tricuspid regurgitation
D. Tricuspid stenosis
Following is TRUE about Carvallo sign
A. Murmur of Tricuspid regurgitation becomes softer during expiration
B. Murmur of Tricuspid regurgitation becomes louder during expiration
C. Murmur of Tricuspid regurgitation becomes louder during inspiration
D. Murmur of Tricuspid regurgitation becomes softer during inspiration
Carvallo sign – What is the mechanism?
During inspiration in Tricuspid regurgitation
-venous blood flow into the right atrium and ventricle are increases
– stroke volume of the right ventricle during systole increases.
– blood flow from the right ventricle into the right atrium is larger during inspiration,
– cause the murmur to become louder during Inspiration
1. What is Carvallo’s sign most commonly associated with?
💬 Explanation: Carvallo’s sign is an auscultatory finding in tricuspid regurgitation, where the murmur becomes louder during inspiration due to increased venous return to the right heart.
2. Which of the following best describes Carvallo’s sign?
💬 Explanation: Carvallo’s sign refers to the increase in intensity of a right-sided systolic murmur (typically tricuspid regurgitation) with inspiration.
3. Why does Carvallo’s sign occur?
💬 Explanation: Inspiration increases venous return to the right heart, making right-sided murmurs louder, as seen in Carvallo’s sign.
4. In which cardiac condition is Carvallo’s sign a key distinguishing feature?
💬 Explanation: Carvallo’s sign helps differentiate tricuspid regurgitation from left-sided murmurs, as it becomes louder with inspiration.
5. Carvallo’s sign helps to differentiate which of the following?
💬 Explanation: Carvallo’s sign differentiates tricuspid regurgitation (right-sided) from mitral regurgitation (left-sided), as the former increases with inspiration.
6. Carvallo’s sign is typically used to differentiate which of the following?
💬 Carvallo’s sign helps differentiate right-sided murmurs (which increase with inspiration) from left-sided murmurs.
7. Which maneuver enhances Carvallo’s sign?
💬 Deep inspiration increases venous return to the right heart, accentuating right-sided murmurs and making Carvallo’s sign evident.
8. In which valvular lesion is Carvallo’s sign most prominently seen?
💬 Carvallo’s sign is classically associated with tricuspid regurgitation, where the murmur increases with inspiration.
9. What is the primary physiological mechanism behind Carvallo’s sign?
💬 Deep inspiration increases venous return to the right side of the heart, which can intensify right-sided murmurs—this is the basis of Carvallo’s sign.
10. Carvallo’s sign is negative in which of the following conditions?
💬 Mitral regurgitation is a left-sided murmur and does not show Carvallo’s sign since it does not increase with inspiration.
11. Carvallo’s sign can be best appreciated using which of the following tools?
💬 Carvallo’s sign is a clinical auscultatory finding best appreciated with a stethoscope during physical examination.
12. Which of the following clinical findings would most likely accompany a positive Carvallo’s sign?
💬 A holosystolic murmur that increases during inspiration is characteristic of tricuspid regurgitation and positive Carvallo’s sign.
13. Which statement is true regarding Carvallo’s sign?
💬 Carvallo’s sign is characterized by the intensification of right-sided heart murmurs (especially tricuspid regurgitation) during inspiration.
14. Which murmur will typically increase in intensity with inspiration?
💬 Among the listed options, **tricuspid regurgitation** is the right-sided murmur that **increases with inspiration**, a hallmark of Carvallo’s sign.
15. Carvallo’s sign is most useful in differentiating:
💬 Carvallo’s sign helps clinicians distinguish **tricuspid regurgitation (right-sided)** from **mitral regurgitation (left-sided)** murmurs.
16. Which of the following mechanisms best explains the Carvallo sign?
💬 The Carvallo sign reflects increased right-sided heart filling during inspiration, enhancing the murmur of tricuspid regurgitation.
17. The Carvallo sign is most useful in distinguishing between which two murmurs?
💬 Carvallo sign helps distinguish tricuspid regurgitation (intensifies with inspiration) from mitral regurgitation (not affected by respiration).
18. Which condition is most likely to demonstrate a positive Carvallo sign?
💬 Tricuspid regurgitation classically exhibits a murmur that becomes louder during inspiration—a hallmark of the Carvallo sign.
19. Carvallo sign relies on which respiratory phase to enhance murmur intensity?
💬 Inspiration increases venous return to the right heart, intensifying right-sided murmurs like tricuspid regurgitation.
20. In a patient with suspected infective endocarditis and a murmur increasing with inspiration, what does Carvallo sign suggest?
💬 A murmur that intensifies during inspiration in infective endocarditis suggests right-sided valve involvement—most commonly the tricuspid valve.
Carvallo sign
| Point | Detail |
|---|---|
| 1️⃣ | Carvallo Sign is a clinical auscultatory sign. |
| 2️⃣ | It helps differentiate right-sided from left-sided heart murmurs. |
| 3️⃣ | Carvallo Sign is positive when a murmur increases during inspiration. |
| 4️⃣ | It indicates a right-sided murmur, usually tricuspid regurgitation. |
| 5️⃣ | Inspiration increases venous return to the right heart, enhancing right-sided murmurs. |
| 6️⃣ | Left-sided murmurs (e.g., mitral regurgitation) typically do not increase with inspiration. |
| 7️⃣ | Named after Dr. José Manuel Rivero Carvallo, a Mexican cardiologist. |
| 8️⃣ | Best appreciated at the lower left sternal border with the patient supine. |
| 9️⃣ | Particularly valuable in diagnosing tricuspid valve disorders. |
| 🔟 | Helps avoid misdiagnosis of mitral regurgitation in the presence of tricuspid regurgitation. |
| 1️⃣1️⃣ | A positive Carvallo sign also suggests elevated right atrial pressures. |
| 1️⃣2️⃣ | Can be accentuated by deep inspiration or sitting forward. |
| 1️⃣3️⃣ | Not useful in severe right heart failure with poor venous return. |
| 1️⃣4️⃣ | Useful during bedside clinical examination in resource-limited settings. |
| 1️⃣5️⃣ | Carvallo sign is most specific when systolic murmur intensity increases with inspiration. |
| 1️⃣6️⃣ | It may help differentiate tricuspid stenosis from mitral stenosis. |
| 1️⃣7️⃣ | Has diagnostic relevance in endocarditis affecting the tricuspid valve. |
| 1️⃣8️⃣ | Should be assessed along with jugular venous pressure and other right-heart signs. |
| 1️⃣9️⃣ | In patients with pacemakers or prosthetic valves, interpretation can be complex. |
| 2️⃣0️⃣ | Still holds value in the era of echocardiography for bedside assessments. |
Cardiology MCQs-8
Most sensitive and specific test for myocardial damage A. Troponin I B. CK-MB C. Lactate dehydrogenase D. Ischemia-modified albumin Which is most specific for myocardial injury? A. Troponin T B. CK-MB C. Troponin I D. Troponin C Which is earliest to peak in myocardial injury? A. Troponin I B. Myoglobin C. Lactate dehydrogenase D. Ischemia-modified albumin Glycogen phosphorylase isoenzyme BB isoform of the enzyme exists in A. Heart and Kidney B. Heart and Brain C. Heart and Liver D. Heart and Pancreas Homocysteine is a cardiac biomarker classified as Biomarkers of A. Myocardial injury B. Myocardial Necrosis C. Hemodynamic stress...
Rivero-Carvallo sign
Accentuation of the murmur of tricuspid stenosis with inspiration. Mexican cardiologist José Manuel Rivero Carvallo (1905–1993) in 1946
