Mitral Regurgitation and Aortic Regurgitation | #105

This is an auscultation example of moderate regurgitation of both the aortic and mitral valves. The first heart sound is minimally decreased due to minimal closure of the mitral valve leaflets in early systole. The second heart sound is normal. There is a rectangular murmur which takes up most of systole and a decrescendo murmur which takes up most of diastole. Both murmurs are of moderate intensity. The combination of the two murmurs creates a to-and-fro sound character. In the anatomy video you see an enlarged left atrium and left ventricle. You see regurgitant turbulent flow into the left atrium from the left ventricle (the systolic murmur) and regurgitant turbulent flow from the aorta into the left ventricular outflow tract (the diastolic murmur).

Auscultation Audio

Technique

The patient's position should be sitting leaning forward.

Auscultation Tips

S1:Minimally reduced intensity
Systole:Rectangular murmur, moderate intensity
Diastole:Decrescendo murmur, moderate intensity

Sound Wave

Observe Cardiac Animation

Play the animation and take note of an enlarged left atrium and left ventricle. Observe regurgitant turbulent flow into the left atrium from the left ventricle (the systolic murmur) and regurgitant turbulent flow from the aorta into the left ventricular outflow tract (the diastolic murmur).

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

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Mitral Regurgitation and Aortic Regurgitation | #105