Complex Murmurs

Mild Aortic Stenosis Moderate and Regurgitation Lesson

patient thorax when auscultating by stethoscope

The patient was sitting leaning forward during auscultation.

Description

This lesson discusses moderate aortic stenosis combined with mild aortic regurgitation in a patient with rheumatic heart disease.

S1 is normal, and S2 is unsplit. An aortic ejection click occurs in systole followed by a diamond-shaped systolic murmur. A high-pitched decrescendo murmur fills the first two thirds of diastole.

In the cardiac animation video, you can see a thickened left ventricle and thickened aortic valve leaflets. Moderate turbulent blood flows across the aortic valve in systole and a mild regurgitant turbulent flow into the left ventricle occurs in diastole. These turbulent blood flows cause the systolic and diastolic murmurs.

Phonocardiogram

Anatomy

Mild Aortic Stenosis Moderate and Regurgitation

In the animation, observe 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.

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: 11/10/2021

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
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)
Heart and Lung Sounds Reference Guide
PracticalClinicalSkills.com