Mitral Stenosis Severe and Regurgitation Mild - Rheumatic Origin

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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.

Mitral Stenosis Severe and Regurgitation Mild - Rheumatic Origin
The recommended auscultation position for the stethoscope is the Mitral position. For this sound, use stethoscope's Diaphragm.


maneuver
The recommended patient position is Supine left side down

Phonocardiogram

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

Heart Animation

Lessons
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Listening Tips
A synopsis of important sound features and timing for this abnormality.
S1: Slightly louder.
Systole: Rectangular, mid pitch in first half of systole.
Diastole: Opening snap then low pitch diamond crescendo murmur.
CaseID103
CourseID28
CourseCaseOrder3
ID93