Heart murmurs causes, symptoms and treatment

First of all, considering the noise in the heart of an adult, they divide it into two types. There are sound phenomena:

The first type indicates that a serious illness occurs in the body or a heart defect occurs. It is characterized by hard sounds, a distinct timbre, sharp and steady intensity, duration (sounds are conducted outside the myocardium, under the scapula or in the axillary region). This type of sound can be heard quite clearly.

Functional – are considered a harmless phenomenon (therefore they are called “innocent”). They are distinguished by softness of the timbre, short duration, low intensity. They are not associated with myocardial diseases and differ in that they are poorly tapped.

Classification of acoustic phenomena in the body occurs and depending on the time of their occurrence. Those that occur when the heart muscle relaxes and the ventricles are filled with blood are called diastolic. Others that occur during contraction of the ventricles of the myocardium at the time of ejection of blood into the aorta are called systolic.

Already at the first appointment with a doctor, you can identify problems in the body

Separation can also be by the nature of occurrence, from which phenomena are distinguished:

  • congenital;
  • acquired (arising from the development of the pathological process in the body).

In most cases, according to doctors, the causes of heart murmurs in an adult are circulatory disorders (or rather, high blood flow). As a rule, after physical exertion, they become even stronger and sharper.

A defect in the interventricular septum (for example, its narrowing) can also cause these sound vibrations. Deformation of the hole will be accompanied by insufficient blood filling of the expanded chamber. This defect can occur due to tissue necrosis after a heart attack or injury.

A mitral valve deflection is also considered a dangerous phenomenon, which ceases to adequately regulate the amount of blood received and cannot prevent the reverse outflow.

Causes of systolic murmurs in the heart can be the result of rheumatism and various diseases in the body (caused by inflammatory and infectious processes).

“Innocent” acoustic vibrations deserve special attention. The causes of such heart murmurs are associated with the occurrence of common diseases that are not related to the cardiovascular system, and other conditions. For instance:

  • obesity;
  • high cholesterol;
  • pneumonia;
  • fluid accumulation;
  • physical stress.

Attention! The phenomenon may occur due to stress or emotional stress.

The main signs that accompany cardiovascular disease and this pathological phenomenon include:

  • blue lips and skin (especially limbs);
  • pain in the chest area;
  • shortness of breath;
  • various cardiac arrhythmias;
  • drops in blood pressure;
  • fatigue;
  • dizziness;
  • fainting or frequent pre-fainting conditions.

Attention! All these symptoms intensify after exercise.

Assessment of the work of the heart is done by assigning various diagnostic methods. During an ultrasound examination of a pregnant woman in a newborn, the state of all organs, including the heart, is studied.

Timely detection and diagnosis of violations of the structure or functioning of the heart can be ensured by such diagnostics:

  • Echocardiography is a very informative procedure when the heart can be seen in three projections.
  • Computed tomography or magnetic resonance imaging – for the simultaneous assessment of the state of many organs and systems.
  • Catheterization – if it is necessary to determine the pressure and oxygen level.

If there is a strange noise in the child’s heart, it is important to fully examine the baby. Serious treatment may sometimes be required, including surgery in a hospital setting.

It is worth knowing that the characteristic of noise can vary depending on their location. For example, there is systolic murmur at the apex of the aorta.

  1. Mitral valve pathology and related acute failure. In this position, the noise is short-lived. Its manifestation occurs early. If this type of noise is fixed, then the following pathologies are revealed in the patient: hypokinesis, chord rupture, bacterial endocarditis, and so on.
  2. Systolic murmur on the left edge of the sternum.
  3. Chronic mitral valve insufficiency. This type of noise is characterized by the fact that they occupy the entire duration of ventricular contraction. The magnitude of the valve defect is proportional to the volume of blood returned and the nature of the noise. This noise is better heard if the person is in a horizontal position. With the progression of heart disease, the patient experiences vibration in the chest. There is also systolic murmur at the base of the heart. Vibration is felt during systole.
  4. Mitral insufficiency of a relative nature. This pathological process lends itself to therapy with proper treatment and adherence to recommendations.
  5. Systolic murmur with anemia.
  6. Pathological disorders of the papillary muscles. This pathology relates to myocardial infarction, as well as to ischemic disorders in the heart. Systolic murmur of this type is variable. It is diagnosed at the end of systole or in the middle. There is a short systolic murmur.

How does the disease occur?

Takotsubo cardiomyopathy can occur even in healthy people. Despite a temporary damage to the heart muscle with an average duration of 7 to 30 days, it can be severe enough to cause the patient to die.

In this article, we will explain what heart wound syndrome is, what are its causes, its symptoms, and what treatment options are.

When the heart has weak muscles, it loses its ability to pump blood properly, leading to a condition called heart failure. Therefore, a patient with cardiomyopathy has typical symptoms of a weak and insufficient heart, and he has noise.

What can cause a pathological phenomenon

The heart is an organ formed mainly by muscles and blood vessels. What we call heart function is simply a synchronized myocardial contraction. These are the muscles that make up the ventricles and atria of the heart.

Myocardial diseases, that is, diseases of the heart muscle, are called cardiomyopathies. Broken heart syndrome is one of several existing forms of cardiomyopathy (referring to cardiomyopathies of inflammatory origin, ischemic, hypertonic, edible alcohol). They cause noise in the heart.

The appearance of heart murmur during the period of bearing a child in women

When a woman is pregnant, the occurrence of processes such as systolic murmurs in her heart is not ruled out. The most common cause of their occurrence is the load on the girl’s body. As a rule, heart murmurs appear in the third trimester.

In the case when a woman fixes them, the patient is placed under more careful control. In a medical institution where she is registered, her blood pressure is constantly measured, her kidney function is checked and other measures are taken to monitor her condition. If a woman will be constantly monitored and implement all the recommendations that doctors give her, then bearing a child will be in a good mood without any consequences.

Heart murmurs during pregnancy are a fairly common occurrence. Most often, their appearance is associated with a change in the hormonal background, which is characteristic of this condition, as well as with an increase in blood volume. A woman usually feels a rapid heartbeat, quickly gets tired, often feels short of breath.

Dyspnea during pregnancy may indicate a problem with the heart system.

Despite the nature of this condition, the presence of noise in the heart, they should not be left without due attention. It is imperative that you consult a cardiologist, undergo an examination for the presence of heart disease and congenital malformations.

History of the disease

Takotsubo cardiomyopathy, in which heart murmurs are observed, was first described in 1990 in Japan. Since then, this form of cardiomyopathy has been increasingly recognized worldwide. Takotsubo is the name of the vessel used in Japan as a trap for capturing the octopi. This form of cardiomyopathy was named Takotsubo because the patients’ left ventricle presented an expanded format similar to a Japanese vessel.

The already mentioned broken heart syndromes or stress myocardiopathy are due to the fact that the disease usually occurs after a strong emotional or physical stress. The main causes of heart murmurs are explained below.

What surveys do

The therapist, hearing a heart murmur in an adult, first suggests a diagnosis, but be sure to refer such a patient for a consultation with a cardiologist. After the examination, depending on each specific case and heard features during auscultation, the doctor prescribes additional diagnostic methods to verify the diagnosis.

  • general blood analysis;
  • blood biochemistry;
  • rheumatological tests;
  • analysis of thyroid hormones;
  • phonocardiography;
  • X-ray of OGK;
  • cardiac catheterization.

Basically, heart murmurs are determined by auscultation (listening). Then assigned:

  • electrocardiogram;
  • echocardiography (a special type of ultrasound, with which you can get an image of the myocardium, measure the speed of blood flow through it and its pressure);
  • angiography (a type of x-ray with a contrast agent);
  • stress tests.

In some cases, myocardial catheterization may be indicated.

Mandatory in the process of examining adult patients are various specific tests of the intensity of the fluctuations (respiration, positional changes, during physical exertion, fibrillation and extrasystole, Valsalva). In addition, samples are prescribed under the influence of certain pharmacological agents (for example, inhalations).

Drug treatment can only be prescribed by a doctor

The very first version of the examination is auscultation (you can watch a video about this). This is a highly informative method that is aimed at carefully listening to heart murmurs that are found in the functioning of the cardiovascular system. By the way, for newborns – this is a mandatory procedure.

Further, a diagnostic examination includes:

  • an electrocardiogram (ECG). It helps to identify abnormalities in the myocardium;
  • echocardiography (type of ultrasound). This examination will help establish the speed of blood flow, as well as its pressure;
  • stress tests;
  • angiography (X-ray examination using a special contrast agent);
  • myocardial catheterization.

Have additional questions

A full examination and study of the problem of excessive sounds in the myocardium includes a measurement of their intensity, and for this several tests are performed:

  • breathing
  • Valsalva (the essence is in forced exhalation with a closed nose and mouth);
  • extrasystoles;
  • fibrillation (uncoordinated contraction of muscle fibers);
  • positional changes (body turns on one or the other side, squats, while lying down – raising legs);
  • pharmacological interventions;
  • arterial occlusion.

Existing treatments

Based on the results obtained after the diagnostic examination, a decision is made on how to treat heart murmurs, or rather the pathology that caused their appearance. It can be:

  • medical methods;
  • maintenance therapy;
  • surgical intervention.

To select a treatment program, the cause of the appearance of these noises in the heart, as well as the age of the patient and the general condition of his body, are taken into account first of all. Diseases of moderate severity often require adequate drug therapy, and today there are quite effective drugs.

Many defects, mitral valve deflection and other serious diseases require surgical intervention. In modern clinics, with the latest, high-tech equipment, such operations are carried out efficiently and safely, they are often prescribed for newborns.

As a supporting therapy, the patient is shown to lead a healthy lifestyle, observing the daily regimen and a good sleep, restriction in sports and reducing physical activity, walking in the fresh air, balanced nutrition.

Important! Periodic medical examinations become mandatory.

Key recommendations

  1. Functional – appear with anemia, fever, pregnancy, thyroid disease.
  2. Accidental (harmless).
  3. Organic – the effects of anatomical changes in valves and septa.

By the nature of localization:

Organic are divided into:

  • pleurocardial – due to adhesions between the pericardium and pleura;
  • pericardial friction noise – observed with pericardial effusion and dry pericarditis.
  • cardiopulmonary (“systolic breathing”) – occurs when sections of lung tissue that were previously compressed by the heart muscle straighten during systole;
  • chordal;
  • muscle;
  • valve.

In relation to the phase of the cardiac cycle:

  • systolic (often found in myocardial infarction, mitral valve insufficiency);
  • diastolic (with rheumatism).

By intensity (evaluated on a six-point scale):

  • 1/6: listen at the maximum concentration of attention;
  • 2/6: the noise is quiet but sonorous enough to catch it right away;
  • 3/6: loud and distinguishable;
  • 4/6: loud and accompanied by trembling on palpation;
  • 5/6: heard when applying the edge of the phonendoscope;
  • 6/6: is heard when the phonendoscope membrane only approaches the auscultation site.

An attentive attitude to one’s health belongs to the main preventive measure; even small diseases should be paid attention to to prevent their transition to inflammatory processes or rheumatism.

The next point is a balanced diet and healthy food. The diet should include fresh vegetables and fruits, cottage cheese, meat, fish. Dried fruits are obligatory in use – dried apricots, raisins.

Every day you need to take walks in the fresh air, go to nature, more often to walk in the park. Important and complete rejection of bad habits, especially – from smoking.

The exact cause of Broken Heart Syndrome is still not entirely understood. We also do not know why the disease mainly affects women after menopause, and why the cardiac muscle of the apex and central part of the left ventricle are local, which are usually affected. It is believed that the cause of this cardiomyopathy may be the release of stress hormones such as adrenaline released during intense experiences.

The most acceptable theory for explaining what causes heart murmurs is that excess stress hormones can lead to diffuse and temporary narrowing of the heart arteries, causing ischemia of the heart muscle and a clinical picture similar to acute myocardial infarction.

It is worth saying that it is necessary to make timely diagnostics to detect noise in the human heart. An important point is to establish the cause of their occurrence. It should be remembered that systolic murmur may mean that a serious pathological process occurs in the human body. In this case, identifying the type of noise at an early stage will help to take all the necessary measures to treat the patient. However, they, too, may not have any serious deviations and will go through a certain time.

It is necessary that the doctor carefully diagnose the noise and determine the cause of its appearance in the body. It is also worth remembering that they accompany a person at different age periods. Do not be frivolous with these manifestations of the body. It is necessary to bring the diagnostic measures to the end.

What is it talking about?

If the patient has sounds inside the body, then this means that the blood flow in the heart vessels is disturbed. There is a widespread belief that systolic murmur is observed in adults.

This means that a pathological process occurs in the human body that indicates some kind of ailment. In this case, it is urgent to undergo a cardiological examination.

Systolic murmur implies its presence between the second heart tone and the first. Sound is recorded on the heart valves or blood flow.

Joyful events are also dangerous.

What are the causes of systolic murmur? There are several basic ones. These include:

  1. Aortic stenosis. It can be either congenital or acquired in nature. This disease occurs due to narrowing of the aorta. With this pathology, the valve walls are fused. This situation complicates the flow of blood inside the heart. Aortic stenosis can be attributed to the most common heart disease in people in adulthood. The consequence of this pathology may be aortic insufficiency, as well as mitral defect. The aortic system is designed in such a way that calcification is produced. In this regard, the pathological process intensifies. It is also worth mentioning that with aortic stenosis, the load on the left ventricle increases. In parallel with this, the brain and heart experience insufficient blood supply.
  2. Aortic insufficiency. This pathology also contributes to the occurrence of systolic murmur. With this pathological process, the aortic valve does not close completely. Infectious endocarditis causes aortic insufficiency. The impetus for the development of this disease is rheumatism. Also, lupus erythematosus, syphilis and atherosclerosis can provoke aortic insufficiency. But injuries and defects of a congenital nature rarely lead to this ailment. A systolic murmur on the aorta suggests that the valve has aortic insufficiency. The reason for this may be the expansion of the ring or aorta.
  3. Washing jumping off an acute course is also the reason that systolic murmurs appear in the heart. This pathology is associated with the rapid movement of fluids and gases in the hollow regions of the heart when they are reduced. They move in the opposite direction. As a rule, this diagnosis is made in case of dysfunction of the dividing walls.
  4. Stenosis. This pathological process is also the cause of systolic murmur. In this case, the narrowing of the right ventricle, namely its tract, is diagnosed. This pathological process refers to 10% of cases of noise. In this situation, they are accompanied by trembling of a systolic nature. The vessels of the neck are particularly exposed to irradiation.
  5. Stenosis of the tricuspid valve. With this pathology, the tricuspid valve narrows. As a rule, rheumatic fever leads to this disease. Patients have indicators such as cold skin, fatigue, discomfort in the neck and abdomen.

The difference is that with Takotsubo cardiomyopathy, the arteries of the heart are not covered with atherosclerotic plaques. When a patient undergoes cardiac catheterization (coronary angiography), there is no obstructive lesion in the coronary arteries.

A broken heart syndrome is often preceded by an intense physical or emotional event. These events do not have to be bad; an older woman may experience stress-induced cardiomyopathy, knowing that she has won millions in the lottery.

Some well-known causes of heart murmur in an adult that are symptoms of the development of Takotsubo cardiomyopathy:

  • The news of the unexpected death of a loved one.
  • Very sad news, such as a diagnosis of cancer in a close relative.
  • Domestic violence.
  • Sudden and unexpected loss of big money.
  • Winning the lottery.
  • Hot nervous discussion with someone.
  • Stormy party.
  • Divorce.
  • Job loss.
  • Car accident.
  • Large financial transactions.
  • Severe asthma attack.

It is important to note that although this is common, not all Takotsubo cardiomyopathies are directly related to a stressful event. In about one third of patients, scientists were unable to identify any factors that caused adult heart murmurs.

Subdivision of noise into species

There is a certain gradation in the separation of data from pathological processes:

  1. Functional systolic murmur. It refers to an innocent manifestation. There is no danger to the human body.
  2. Organic systolic murmur. Such a noise character indicates the presence of a pathological process in the body.

An innocent type of noise can indicate that there are other processes in the human body that are not related to heart disease. They are of a soft nature, not long, have a weakly expressed intensity. If a person reduces physical activity, then the noise will disappear. Data may vary depending on the posture of the patient.

Sound effects of a systolic nature occur due to septal disorders and valvular. Namely, in the human heart there is a dysfunction of the septa between the ventricles and atria. They differ in the nature of the sound. They are solid, tough and stable. There is a gross systolic murmur, its long duration is recorded.

These sound effects extend beyond the borders of the heart and are reflected in the axillary and interscapular zones. If a person subjected his body to exercises, then sound abnormalities persist after they are over. During physical activity, noise is amplified. Organic sound effects that are present in the heart are independent of body position. They are equally well heard in any position of the patient.

How is the disease manifested

The clinical picture of a broken heart syndrome is very similar to the symptoms of acute myocardial infarction. Chest pain and shortness of breath are common symptoms for two ailments.

Other common signs and symptoms are:

  • hypotension;
  • fainting;
  • heart murmur;
  • cardiac arrhythmia.

Almost 10% of patients develop cardiogenic shock, with severe hypotension, loss of consciousness, and pulmonary edema. These are patients with a high risk of mortality. As in patients with acute myocardial infarction, stress cardiomyopathy also often causes changes in echocardiography typical of coronary artery ischemia and changes in the cost of troponin, which currently shows a blood test used to diagnose heart attack.

Echocardiography helps to identify areas of the left ventricle with poor contractility – a signal that is also usually present in acute heart attack. Laboratory tests, as a rule, confirm the possibility of a heart attack, and emergency cardiac catheterization is ultimately applied to most patients.

As already mentioned, the test shows that these patients do not show signs of coronary artery obstruction, excluding heart attack as a cause of functional noise in the heart. It was at this time that the doctor began to think about the hypothesis of stressful myocardiopathy.

How to treat a disease

There is no specific treatment for Takotsubo cardiomyopathy. In general, treatment is only prophylactic, aimed at symptoms, until the heart muscle has time to recover. This process usually takes 1 to 4 weeks.

In general, the drugs used are the same as those for heart failure, especially diuretics and ACE inhibitors. Mortality in a broken heart syndrome is low, less than 5%. The vast majority of patients can get a full recovery of heart function in a couple of weeks.

The fact that a person had an attack of Takotsubo cardiomyopathy after a stressful event does not mean that she will have a similar picture if she is exposed to a new influence of strong emotions. In most cases, “broken heart syndrome” is the only event in a patient’s life.

Why does the noise appear in children?

Why can there be a heart murmur in a child? There are many reasons. Below will be listed the most common. So, there may be heart murmurs in the child due to the following pathologies:

  1. Violation of the atrial septum. In this case, we are talking about the absence of tissue in it. This situation leads to the discharge of blood. The volume of blood discharged depends on the size of the defect and the compliance of the ventricles.
  2. An abnormal state of the venous return of the lungs of a child’s body. There are cases of abnormal formation of pulmonary veins. The essence of this is that the pulmonary veins do not communicate with the atrium on the right. They can grow together with the veins of a large circle.
  3. Coarctation aortic. In this case, we are talking about narrowing of the thoracic aorta. A child is diagnosed with heart disease. Segmental aortic lumen is smaller than expected. This pathology is treated through surgery. In case of failure to prov >

Why do children get sick?

Noises in the heart of a child, the reasons for which we will consider later, are very dangerous if the diagnosis is not timely performed.

According to cardiologists, most children are characterized by the presence of atypical sounds in the heart at different ages. This is not always a sign of the development of a pathological condition. The disappearance of symptoms can occur by itself. But these children should always be monitored by specialists.

When listening to a child, the doctor should assess the level of noise power, timbre, duration and location of this phenomenon. Analysis of heart murmurs in newborns and older children and the results of this process allow us to determine one of the causes of the phenomenon:

  • A false chord is a false noise in which the presence of abnormal chords is present inside the heart ventricles. This condition is a deviation from the norm, it can affect the change in heart rate. But the presence of these structures is not dangerous due to the lack of influence on the system of intracardiac blood flow. Many children manage to defeat this ailment, the cardiovascular system is prone to restore the circulatory system, when the newborn adapts to living conditions outside the womb.

Congenital heart defects in children

It is worth saying a few words about newborn babies. Immediately after birth, a complete examination of the body. Including listening to the heart rate. This is done in order to exclude or detect any pathological processes in the body.

With such an examination, the possibility of detecting any noise is present. But they do not always have to be cause for concern. This is due to the fact that noises are quite common in newborn babies. The fact is that the child’s body is rebuilt under the external environment. The heart system is reconfigurable, so various noises are possible.

The presence of congenital noises in the baby’s body is determined during the first three years of life. Noises in newborn babies may indicate that during development before birth, the heart was not fully formed for various reasons. In this regard, after birth, the baby is recorded noise. They talk about congenital heart defects. In the case when pathologies have a high risk for the health of the child, doctors decide on the surgical method of treating a particular pathology.

How are diagnostic steps taken to detect heart murmur?

First of all, the doctors are faced with the task of determining whether there is a heart murmur or not. The patient undergoes an examination such as auscultation. During her, a person must first be in a horizontal position, and then in a vertical position. Also, listening is done after exercise in the position on the left side on the inhale and exhale.

For example, with mitral valve disease, it is necessary to listen to the apex of the heart. But with malformations of the tricuspid valve, it is better to examine the lower edge of the sternum.

An important point in this matter is the exclusion of other noises that may be present in the human body. For example, with a disease such as pericarditis, noise can also occur.

Diagnostic Options

In order to diagnose noise effects in the human body, special technological tools are used, namely: FCG, ECG, radiography, echocardiography. Radiography of the heart is done in three projections.

There are patients to whom the above methods may be contraindicated, since they have other pathological processes in the body. In this case, invasive methods of examination are prescribed to the person. These include sensing and contrast methods.

Auscultation allows you to identify heart murmurs, but to establish the causes of their occurrence in an adult, you will also need to carry out several additional examinations. Therefore, experts mainly prescribe:

  • Electrocardiography, which makes it possible to measure the heart rate and detect hidden noises;
  • Ultrasound of the heart, showing specific changes in the cardiovascular system and allowing to assess the condition of the valves;
  • Chest X-ray – performed to detect stagnation in the lungs and changes in heart configurations;
  • Biochemical analysis of blood and KLA, as well as blood tests for thyroid hormones.

To summarize

The occurrence of noise in the heart is an abnormal phenomenon. In no case should you ignore this condition, as it can signal serious problems.

If the noise is diagnosed in a baby, both congenital heart problems and acquired diseases can occur. In the second case, the reason often lies in complications after infectious diseases. The solution to the problem varies from medical treatment to surgery in a hospital setting.


Also, for accurate diagnosis of the patient’s condition, namely, to measure the intensity of noise, various tests are used. The following methods are used:

  1. Exercise patient load. Isometric, isotonic, carpal dynamometry.
  2. The patient’s breathing is heard. It is determined whether the noise exacerbates as the patient exhales.
  3. Extrasystole.
  4. Change in the poses of the person being examined. Namely, raising legs when a person is standing, crouching and so on.
  5. Breath holding. This examination is called a Valsalva test.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.