José Manuel Rivero Carvallo (1905 – 1993) was a Mexican cardiologist.
Rivero-Carvallo dedicated his life to the study of the tricuspid valve and made significant contributions to it’s pathology and mechanics.
Rivero-Carvallo is eponymously remembered for his 1946 description of the Rivero Carvallo manouver to assist in the clinical evaluation of tricuspid stenosis and regurgitation.
- Born April 1, 1905 Tehuacán, Mexico
- 1928 – Medical school, city of Puebla
- 1932 – Doctorate, University of the Sorbonne. Thesis: ‘La pression artérielle au tours de l’anesthésie et de certaines interventions chirurgicales‘
- 1933 – Intern, Hôpital de la Pitié with Louis Henri Vaquez
- 1934 – Cardiology, Mexico’s General Hospital with Ignacio Chávez Sánchez (1897-1979) – founder of establish the first cardiology, cardiology journal, and cardiology hospital in Mexico.
- 1944 – Founding member of the National Institute of Cardiology (INC) of Mexico
- 1946 – Described intensification of tricuspid regurgitation (systolic) murmur during inspiratory apneoa.
- 1951 – Described ‘atrium papyraceum’ for thinning of the right atrial wall in patients with chronic tricuspid stenosis.
- Died 1993
Accentuation of the murmur of tricuspid regurgitation and tricuspid stenosis with inspiration. Auscultation is performed during post-inspiratory apnoea and the loudness of the systolic murmur is compared to its loudness during post-expiratory apnoea.
1946 – Described intensification of tricuspid regurgitation (systolic) murmur during inspiratory apnea and published Signo para el diagnóstico de las insuficiencias tricuspídeas
1951 – Noted that tricuspid stenosis murmurs may require several inspiratory efforts to accentuate the murmur in inspiration. On examining the clinical findings of tricuspid stenosis during life and comparing directly to the autopsy findings post mortem he described ‘atrium papyraceum‘ for thinning of the right atrial wall in patients with chronic tricuspid stenosis.
1962 – Rivero-Carvallo described the ‘sign of the double apical thrust‘ in patients with chronic tricuspid acoustic phenomena shifted to the left. Following pathological and clinical observations he concluded that, in chronic disease, the right atrium and ventricles enlarge, rotating the heart clockwise along its longitudinal axis and counterclockwise along its transverse axis, with the right ventricle occupying the anterolateral aspect of the chest.
He designed a manouver to determine the ‘true’ apex:
The patient is placed on his back and the apex area is located. The palm of the hand is placed over this area while the fingertips are placed from the fourth to the seventh intercostal spaces at the level of the left axillary line. Without separating the hand, the patient is asked to turn to his left, at which time a new apical thrust appears under the tips of the explorer’s fingers, identifying the true apex.
- Rivero-Carvallo JM. Signo para el diagnóstico de las insuficiencias tricuspídeas [A sign for the diagnosis of tricuspid insufficiency]. Archivos del Instituto de Cardiología de México, 1946; 16: 531–540.
- Rivero-Carvallo JM. Un nuovo segno diagnostico della insufficienza tricuspidale [A new diagnostic sign of tricuspid insufficiency]. Cuore e circolazione. 1947; 31(3-4): 54
- Rivero-Carvallo JM. Semiología de las lesiones tricuspídeas. Archivos del Instituto de Cardiología de México. 1951; 21 567–593.
- Rivero-Carvallo JM, Garza de los Santos A. Real and apparent apical impulse in tricuspid lesions: differentiation of mitral and tricuspid murmurs and sounds. Am J Cardiol. 1959; 4: 367–372.
- Rivero Carvallo JM. El signo de doble choque apexiano [The sign of the double apex shock]. Archivos del Instituto de Cardiología de México 1962; 32(5): 387–399.
- Rivero Carvallo JM. The left bronchial compression syndrome. Left atrial enlargement and dilatation of the descending aorta. Am J Cardiol. 1962 Apr;9:521-7.
- Rivero-Carvallo JM, Ramírez-Jaime MH. Atrium papyraceum. The clinical diagnosis of the paper-thin right atrium. Am J Cardiol. 1965; 16(3):369-378
- Rivero-Carvallo JM, Ramírez-Jaime H. El diagnóstico de la aurícula papirácea [The diagnosis of papyraceous auricle]. Archivos del Instituto de Cardiología de México. 1966; 36: 464–482
- de Micheli A. Centenary of the birth of a distinguished Mexican cardiologist, Dr. José Manuel Rivero Carvallo. Arch. Cardiol. Mex. 2005; 75(1)
- Soto-Perez-de-Celis E. José Manuel Rivero-Carvallo and the Tricuspid Valve. Clin Cardiol. 2011 Mar;34(3):E9-11.
- Suto M et al. Reversed Rivero-Carvallo’s sign confirmed by blood flow analysis using cardiac magnetic resonance imaging in a patient with straight back syndrome. Echocardiography. 2017 Oct 29.
- Toso M, Innocenti P. [The Rivero-Carvallo maneuver in the diagnosis of tricuspid insufficiency. Conventional and intracavitary phonocardiographic study]. Cuore Circ. 1966; 50(2): 94-102.
- Robbins A, Zhang G. Name that murmur. LITFL 2019
the person behind the name