Complex Conditions

Aortic Stenosis Moderate and Regurgitation Mild - Rheumatic Origin Sounds

This is an example of moderate aortic stenosis combined with mild aortic regurgitation in a patient with rheumatic heart disease.

The first heart sound is normal.

The second heart sound is unsplit.

There is an aortic ejection click in systole followed by a diamond-shaped systolic murmur.

There is a high-pitched decrescendo murmur which fills the first two thirds of diastole.

In the anatomy tab you can see a thickened left ventricle and thickened but mobile aortic valve leaflets. There is moderate turbulent flow across the aortic valve in systole and mild regurgitant turbulent flow into the left ventricle in diastole.

The turbulent blood flow causes the systolic and diastolic murmurs.

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The recommended auscultation position for the stethoscope is the Aortic 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

1	Mitral Regurgitation - Severe
2	Tricuspid Regurgitation - Severe
3	Mitral Stenosis Severe and Regurgitation Mild - Rheumatic Origin
4	Aortic Stenosis Moderate and Regurgitation Mild - Rheumatic Origin
5	Mitral Regurgitation and Aortic Regurgitation
6	Acute Pericarditis

Practice Drill

Listening Tips
A synopsis of important sound features and timing for this abnormality.
Systole: Aortic ejection click followed by diamond shaped murmur.
Diastole: High pitch decrescendo murmur.

CaseID	104
CourseID	28
CourseCaseOrder	4
ID	94