Carey Coombs murmur

Description

Carey Coombs murmur is short mid-diastolic murmur caused by active rheumatic carditis with mitral-valve inflammation. First described by Carey Franklin Coombs in 1907.

Similar to the mid-diastolic rumble of mitral stenosis. Clinically distinguished from mitral stenosis by the absence of an opening snap; presystolic accentuation; or a loud first sound. Carey Coombs murmur which is now largely obsolete due to the eradication of rheumatic heart disease.

History of the Carey Coombs murmur

In 1907, Carey Coombs described the murmur as:

Next the apical second sound becomes doubled and then, but often not till some time after, a murmur is added to the second half of this second sound. This, hard to distinguish at first, lengthens and strengthens till at last it runs into the beginning of the next cycle, becoming, in fact, a pre-systolic murmur. This is not as rough and loud as that of mitral obstruction and it is not due to valvular disease.

Bristol Medico-Chirurgical Journal. 1907

Associated Persons

• Carey Franklin Coombs (1879-1932)

References

Historical references

• Coombs CF. Rheumatic Carditis in Childhood. Bristol Medico-Chirurgical Journal. 1907 Sep; 25(97): 193–200.

Review articles

• Wood P. Discussion of the management of rheumatic fever and its early complications. Proceedings of the Royal Society of Medicine 1950; 43(3): 195-199.
• Besterman EMM. Phonocardiography in acute rheumatic carditis. Br Heart J 1955;17:360-72.
• Ma I, Tierney LM. Name that murmur–eponyms for the astute auscultician. N Engl J Med. 2010 Nov 25;363(22):2164-8.
• Robbins A, Zhang G, Cadogan M. Name that murmur. LITFL 2022

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