Aortic Stenosis Moderate and Regurgitation Mild - Rheumatic Origin

This is an example of moderate aortic stenosis combined with mild aortic regurgitation in a patient with rheumatic heart disease. The first heart sound is normal. The second heart sound is unsplit. There is an aortic ejection click in systole followed by a diamond-shaped systolic murmur. There is a high-pitched decrescendo murmur which fills the first two thirds of diastole. In the anatomy video you can see 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.

Auscultation Sound From Lesson

Patient Recording

Aortic Stenosis Moderate and Regurgitation Mild - Rheumatic Origin

Patient Recording - Half Speed Playback

Position

The patient's position should be sitting leaning forward.

Listening Tips

Systole:Aortic ejection click followed by diamond shaped murmur
Diastole:high-pitch decrescendo murmur

Waveform (Phonocardiogram)

Observe Cardiac Animation

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

EKG heart rhythm modules: Thomas O'Brien.
EKG monitor simulation developer: Steve Collmann
12 Lead Course: Dr. Michael Mazzini, MD.
Spanish language EKG: 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, 5th Edition Kathryn Booth and Thomas O'Brien
ISBN10: 1260064778, ISBN13: 9781260064773
McGraw Hill, 2019
Rapid Interpretation of EKG's, Sixth Edition
Dale Dublin
Cover Publishing Company
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

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