Mitral Regurgitation - Severe

This is an example of severe mitral regurgitation which is caused by degeneration of the mitral valve leaflets. The first heart sound is normal. The second heart sound is widely split. Following the second heart sound there is a third heart sound gallop. There is a loud, rectangular, pansystolic murmur. There is a brief, rumbling, diamond-shaped diastolic murmur immediately following the third heart sound. In the anatomy video you can see the enlarged left atrium and left ventricle. You can see the turbulent blood flow from the left ventricle into the left atrium. This is the systolic murmur. You can see the brief turbulent blood flow from the left atrium to the left ventricle in diastole. This is caused by too much blood in the left atrium which forces blood back into the ventricle during diastole producing the flow rumble.

Auscultation Sounds

Patient Recording

Patient Recording - Half Speed Playback

Position

The patient's position should be supine.

Listening Tips

Systole:Rectangular, loud murmur
S2:Widely split
Diastole:S3 followed by a diamond shaped, brief murmur

Waveform (Phonocardiogram)

Observe

//embedding heart animation

Review the cardiac animation and notice the enlarged left atrium and left ventricle. Observe the turbulent blood flow from the left ventricle into the left atrium. This is the systolic murmur. You can see the brief turbulent blood flow from the left atrium to the left ventricle in diastole. This is caused by too much blood in the left atrium which forces blood back into the ventricle during diastole producing the flow rumble.

Authors

These authors contributed the audio recordings and text found in this reference guide: Jon Keroes, MD,Diane Wrigley, PA, and David Lieberman.
Medically reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.

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