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Case Reports
. 2009 May;48(3):300-2.

The 'mill-wheel' murmur and computed tomography of intracardiac air emboli

Bernard J Rubal  1 , Alisa Leon, Belinda L Meyers, Christopher M Bell
Affiliations
Case Reports

The 'mill-wheel' murmur and computed tomography of intracardiac air emboli

Bernard J Rubal et al. J Am Assoc Lab Anim Sci. 2009 May.

Abstract

The 'water-wheel' or 'mill-wheel' murmur is classically associated with large intracardiac air emboli and described as a "characteristic splashing auscultatory sound due to the presence of gas in the cardiac chambers." We used 64-slice computed tomography (slice thickness, 0.5 mm; revolution time, 400 msec) and 3D fly-through software imagery to capture previously unreported intracardiac air-blood interface dynamics associated with this murmur and ineffective right ventricular contraction in a porcine model.

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Figures

Figure 1.
Figure 1.
Fly-through (lower left panel) view and planar images (upper left, upper right, and lower right) of an air embolus within the right ventricle, demonstrating reflected waves at the air–blood interface. Arrows demonstrate fluid-surface features consistent with bubbles within the right ventricle. A, anterior; P, posterior; L, left; R, right; S, superior; I, inferior.
Figure 2.
Figure 2.
Two rotated views of air (bubble) accumulation in the right ventricle (RV), right atrium (RA), pulmonary artery (PA), and extracardiac thoracic veins (tubular).
See this image and copyright information in PMC

References

    1. Brechner VL, Bethune RW. 1971. Recent advances in monitoring pulmonary air embolism. Anesth Analg 50:255–261 - PubMed
    1. Deceuninck O, De Roy L, Moruzi S, Blommaert D. 2007. Images in cardiovascular medicine. Massive air embolism after central venous catheter removal. Circulation 116:e516–e518 - PubMed
    1. Durant TM, Long J, Oppenheimer MJ. 1947. Pulmonary (venous) air embolism. Am Heart J 33:269–281 - PubMed
    1. Groell R, Schaffler GJ, Rienmueller R, Kern R. 1997. Vascular air embolism: location, frequency, and cause in electron-beam CT studies of the chest. Radiology 202:459–462 - PubMed
    1. Husain S, Ahmed L, Al-Sawwaf M. 2006. Venous air embolism from intravenous CT contrast administration. J Am Coll Surg 202:197. - PubMed

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