Diastolic Murmurs

Aortic Regurgitation - Mild Auscultation Lesson with Recordings

Virtual Auscultation

patient torso with stethoscope chestpiece

The patient's position is sitting leaning forward.

Lesson

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.

Waveform

Heart Sounds Video

Authors and Sources

Authors and Reviewers

Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
Lung sounds by Diane Wrigley, PA
Respiratory cases: William French
David Lieberman, Audio Engineering
Heart sounds mentorship by W. Proctor Harvey, MD
Special thanks for the medical mentorship of Dr. Raymond Murphy
Reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
Last Update: 12/11/2022

Sources

Heart and Lung Sounds Reference Library Diane S. Wrigley
Publisher: PESI
Impact Patient Care: Key Physical Assessment Strategies and the Underlying Pathophysiology
Diane S Wrigley & Rosale Lobo
Practical Clinical Skills: Lung Sounds
Essential Lung Sounds Diane S. Wrigley, PA-C
Published by MedEdu LLC
PESI Faculty - Diane S Wrigley
Case Profiles in Respiratory Care 3rd Ed, 2019
William A.French
Published by Delmar Cengage
Essential Lung Sounds by William A. French
Published by Cengage Learning, 2011
Understanding Lung Sounds Steven Lehrer, MD
Clinical Heart Disease W Proctor Harvey, MD
Clinical Heart Disease
Laennec Publishing; 1st edition (January 1, 2009)