Index
We are talking about a clinical sign commonly associated with aortic regurgitation.
In 19th century Europe, a disease such as syphilis infection was widespread.
Syphilitic aortitis, which resulted in aortic root dilation and severe aortic valve regurgitation, was quite common.
Without good therapy, medical or surgical, available during that period, the disease was allowed to progress. So many people developed severe congestive heart failure from aortic valve regurgitation.
This led to physical examination findings described by several physicians, who attempted to diagnose aortic insufficiency as the cause of an individual’s congestive heart failure.
Aortic regurgitation occurs when the leaflets do not adjust at the time of closure, the blood returns from the aorta to the left ventricle due to the pressure gradient between the vessel and the ventricular cavity in diastole.
Peripheral signs
Many peripheral signs of aortic regurgitation have been identified and named by the last name of the physician who first described it, such as:
- Corrigan pulse.
- De Musset sign.
- Woman’s sign.
- Quincke’s sign.
- Traube’s sign.
- Duroziez sign.
- Hill sign.
- Signo de Shelly.
- Signo de Rosenbach.
- Signo de Becker.
- Gerhardt’s sign.
- Mayne’s sign.
- Signo de Landolfi.
History of the Musset sign
Of the aforementioned signs, these are named in honor of the doctors who described them. However, the sign of Musset was named after the patient whose name was Alfred de Musset (1810-1857), a romantic poet and playwright of French nationality.
Certainly, this fact was unknown at the time and it was not until many years later, when the French doctor Armand Delpeuch, when reading the biography of Musset, which was written by his brother Paul de Musset, discovered something in one of the fragments of the book that catches your attention.
In this biography, a morning event is described in which Musset is having breakfast with his brother and mother. In this breakfast scene, they both observe a rhythmic movement of his head in Musset.
Musset places several of his fingers on his neck, while telling them that this dreadful disease had a cure through a technique and that it was not only simple but also inexpensive. As he did this the rhythmic “dance” of his head would stop.
Armand Delpeuch associated the fact that when Musset pressed the arteries in his neck with his fingers, he limited the flow of blood and as the pulse was not transmitted, his head stopped moving.
This led him to associate this movement with aortic insufficiency and as a consequence he gave the sign the surname of the poet, as it is known today.
Musset’s sign
De Musset’s sign is a rhythmic movement or a shaking of the head, it is a visible sign synchronized with the arterial pulsation in patients with aortic insufficiency.
Assent is an indication that the patient feels the systolic pulse due to increased pulse pressure resulting from aortic regurgitation or regurgitation, in which blood from the aorta regurgitates into the left ventricle due to a defect in the aortic valve. .
Causes
Like Corrigan’s sign, Musset’s sign is a manifestation of the collapsing pulse that is present in aortic regurgitation.
Causes of Musset’s sign include rheumatic fever and aortic aneurysm.
Also syphilitic aortitis is an inflammation of the aorta artery, caused by syphilis, which ultimately causes aortic insufficiency.
Aortic insufficiency, as its name implies, causes the aorta artery to be insufficient to propel blood from the heart to the head, which ends up causing the “arterial dance” characteristic of the Sign of Musset.
Musset’s sign condition is aggravated by alcohol consumption.
Diagnosis
Doctors use various tests to determine the problem. Common diagnostic tests for aortic regurgitation require a physical exam, including listening to a diastolic murmur, the femoral pulses, with a stethoscope.
The most common physical examination finding in patients with aortic regurgitation is a high-frequency decreasing diastolic murmur heard in the third or fourth intercostal space at the left sternal border.
Treatment
Musset’s sign disappears after implantation of a pacemaker.
