Diastolic Murmurs

Aortic Regurgitation - Mild

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This is an example of mild aortic regurgitation which can be caused by a bicuspid (thickened) aortic valve.

The first heart sound is diminished due to premature closure of the mitral valve leaflets.

An aortic ejection click follows the first heart sound by 75 milliseconds.

S2 is normal.

Systole is silent.

A high pitched decrescendo murmur occupying the first half of diastole can be heard starting immediately after the second heart sound.

The murmur is best heard at Erb's Point and can be accentuated by having the patient sitting up and leaning forward holding his breath after expiration.

In the animation you can see the turbulent blood flow from the aorta into the left ventricle during early diastole. You can see the minimally thickened aortic valve leaflets.

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The recommended auscultation position for the stethoscope is the Erbs-Point position. For this sound, use stethoscope's Diaphragm.

maneuver

The recommended patient position is Sitting leaning forward

Phonocardiogram

This waveform plots sound amplitude on the vertical axis against time on the horizontal axis.

Heart Animation

Lessons

Aortic Regurgitation - Mild
Pulmonic Regurgitation - Mild
Mitral Stenosis - Mild
Mitral Stenosis - Moderate
Mitral Stenosis - Severe
Tricuspid Stenosis - Moderate

Practice Drill

Listening Tips
A synopsis of important sound features and timing for this abnormality.
S1: Can be soft.
Systole: Murmur may be present.
Diastole: Early diastole murmur.

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