Auscultation in Primary Care Aortic Stenosis (Diamond Shaped Systolic Murmur) Lesson Waveform Video This is an auscultation example of a diamond shaped systolic murmur associated with aortic stenosis.The first and second heart sounds are normal. The murmur starts shortly after the first heart sound and ends before the second heart sound.The murmur is mid to high pitched.The anatomy tab shows a markedly thickened left ventricle. The aortic valve leaflets are thickened and immobile. The murmur is caused by turbulent flow across the stenotic aortic valve. play pause Maneuver:Sitting Chestpiece Position:Aortic Chestpiece:Diaphragm Table of Contents Introduction First and Second Heart Sounds - Normal and Unsplit First and Second Heart Sounds - Reduced Intensity Second Heart Sound - Splitting Third Heart Sound Gallop Fourth Heart Sound Gallop Third and Fourth Heart Sound Gallop Summation Gallop at 120 beats per minute Second Heart Sound - Fixed Splitting Mid-Systolic Click Mitral Valve Leaflet Prolapse Aortic Stenosis (Diamond Shaped Systolic Murmur) Aortic Regurgitation (Decrescendo Diastolic Murmur) Mitral Regurgitation (pansystolic Murmur) Mitral Stenosis (Diastolic Murmur)