This is an example of severe mitral stenosis combined with mild mitral regurgitation in a patient with rheumatic heart disease.
The first heart sound is slightly louder than normal.
The second heart sound is unsplit.
There is an opening snap fifty milliseconds after the second heart sound.
There is a low-frequency murmur filling all of diastole. The first two-thirds of the murmur is diamond shaped and the last third is a crescendo.
There is a rectangular medium frequency murmur which fills the first half of systole.
In the anatomy video you can see an enlarged left atrium and thickened mitral valve leaflets which barely moved. The turbulent blood flow represents the systolic and diastolic murmurs.
Mitral Stenosis Severe and Regurgitation Mild - Rheumatic Origin Audio
Technique
The patient's position should be supine left side down.
Auscultation Tips
S1:Slightly louderSystole:Rectangular, mid-pitch in first half of systole
Diastole:Opening snap then low-pitch diamond crescendo murmur
Sound Wave
Observe Cardiac Animation
Review the animation. Notice an enlarged left atrium and thickened mitral valve leaflets which barely moved. The turbulent blood flow represents the systolic and diastolic murmurs.
Authors and Sources
Authors and Reviewers
- ECG heart rhythm modules: Thomas O'Brien.
- ECG monitor simulation developer: Steve Collmann
-
12 Lead Course: Dr. Michael Mazzini, MD.
- Spanish language ECG: Breena R. Taira, MD, MPH
- Medical review: Dr. Jonathan Keroes, MD
- Medical review: Dr. Pedro Azevedo, MD, Cardiology
- Last Update: 11/8/2021
Sources
-
Electrocardiography for Healthcare Professionals, 6th Edition
Kathryn Booth and Thomas O'Brien
ISBN10: 1265013470, ISBN13: 9781265013479
McGraw Hill, 2023 -
Rapid Interpretation of EKG's, Sixth Edition
Dale Dublin
Cover Publishing Company -
EKG Reference Guide
EKG.Academy -
12 Lead EKG for Nurses: Simple Steps to Interpret Rhythms, Arrhythmias, Blocks, Hypertrophy, Infarcts, & Cardiac Drugs
Aaron Reed
Create Space Independent Publishing -
Heart Sounds and Murmurs: A Practical Guide with Audio CD-ROM 3rd Edition
Elsevier-Health Sciences Division
Barbara A. Erickson, PhD, RN, CCRN -
The Virtual Cardiac Patient: A Multimedia Guide to Heart Sounds, Murmurs, EKG
Jonathan Keroes, David Lieberman
Publisher: Lippincott Williams & Wilkin)
ISBN-10: 0781784425; ISBN-13: 978-0781784429 - Project Semilla, UCLA Emergency Medicine, EKG Training Breena R. Taira, MD, MPH
-
ECG Reference Guide
PracticalClinicalSkills.com
Mitral Stenosis Severe and Regurgitation Mild - Rheumatic Origin | #103
