Complex Conditions

Mitral Regurgitation and Aortic Regurgitation Sounds

This is an auscultation example of moderate regurgitation of both the aortic and mitral valves.

The first heart sound is minimally decreased due to minimal closure of the mitral valve leaflets in early systole. The second heart sound is normal.

There is a rectangular murmur which takes up most of systole and a decrescendo murmur which takes up most of diastole. Both murmurs are of moderate intensity.

The combination of the two murmurs creates a to-and-fro sound character.

In the anatomy tab you see an enlarged left atrium and left ventricle.

You see regurgitant turbulent flow into the left atrium from the left ventricle (the systolic murmur) and regurgitant turbulent flow from the aorta into the left ventricular outflow tract (the diastolic murmur).

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The recommended auscultation position for the stethoscope is the Mitral 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.
S1: Minimally reduced intensity.
Systole: Rectangular murmur, moderate intensity.
Diastole: Decrescendo murmur, moderate intensity.

CaseID	105
CourseID	28
CourseCaseOrder	5
ID	95