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.
Aortic Regurgitation - Mild Audio
Technique
The patient's position should be sitting leaning forward.
Auscultation Tips
S1:Can be softSystole:Murmur may be present
Diastole:Early diastole murmur
Sound Wave
Observe Cardiac Animation
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
Aortic Regurgitation - Mild | Auscultation Cheat Sheet with Sounds & Video | #94
