Auscultation Training by Repetition

Mitral Stenosis Severe and Regurgitation Mild - Rheumatic Origin

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• pause

Listen for 2-3 minutes

Supine left side down

Diaphragm

Listening Tips

S1: Slightly louder.
Systole: Rectangular, mid pitch in first half of systole.
Diastole: Opening snap then low pitch diamond crescendo murmur.

Repetition Training - More Heart Sounds

Table of Contents

1	Patent Ductus Arteriosus	109
2	Mitral Regurgitation and Aortic Regurgitation	105
3	Mitral Stenosis Severe and Regurgitation Mild - Rheumatic Origin	103
4	Aortic Stenosis Moderate and Regurgitation Mild - Rheumatic Origin	104
5	Tetralogy of Fallot	112
6	Mitral Valve Prolapse with Mid Systolic Click - Standing	131

               
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Lesson Text

This is an example of severe mitral stenosis combined with mild mitral regurgitation in a patient with rheumatic heart disease. The first heart sound is slightly louder than normal. The second heart sound is unsplit. There is an opening snap fifty milliseconds after the second heart sound. There is a low frequency murmur filling all of diastole. The first two-thirds of the murmur is diamond shaped and the last third is a crescendo. There is a rectangular medium frequency murmur which fills the first half of systole. In the anatomy tab you can see an enlarged left atrium and thickened mitral valve leaflets which barely moved. The turbulent blood flow represents the systolic and diastolic murmurs.

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soundID	81
maneuver	Supine left side down
Title	Mitral Stenosis Severe and Regurgitation Mild - Rheumatic Origin
Position	Mitral
realSoundID
caseID	103
S1	Slightly louder
Systole	Rectangular, mid pitch in first half of systole
S2
Diastole	Opening snap then low pitch diamond crescendo murmur
features
lung sounds	False
chestpiece	Diaphragm