Diastolic Murmurs

Pulmonic 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 pulmonic regurgitation which can be caused by an infection of the pulmonic valve leaflets. The first and second heart sounds are normal (S2 is split). 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 the pulmonic area and can be accentuated by having the patient sitting up and leaning forward. The intensity of the murmur increases with inspiration, indicating the right-sided origin of the murmur. In the animation you can see the turbulent blood flow from the pulmonary artery into the right ventricle during early diastole. You can see the minimally thickened pulmonic 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)