Valve incompetence allows backflow from aorta to ventricle. Caused by
rheumatic heart disease, endocarditis, aortic diseases (Marfan’s syndrome, medial
necrosis), syphilis, ankylosing spondylitis, dissection, cardiac trauma.
|Type and Detection
||Heard with diaphragm, patient sitting and leaning forward; Austin-Flint murmur
heard with bell; ejection click heard in 2nd intercostal space
|Findings on Examination
||Early diastolic, high pitch, blowing, often with diamond-shaped midsystolic murmur,
sounds often not prominent; duration varies with blood pressure; low-pitched rumbling
murmur at apex common (Austin-Flint); early ejection click sometimes present.
ventricular hypertrophy, prominent prolonged apical impulse down and to left Pulse
pressure wide; water-hammeror biferiens pulse common in carotid, brachial, and femoral
|Heart Sound Components
||S1 soft; S2 split may have tambour- like quality; M1
and A2 often intensified; S3-S4 gallop is common.
|Normal Heart Sound (441K)|
|Aortic Stenosis (392K)|
|Mitral Stenosis (424K)|
|Pulmonary Stenosis (438K)|
|Mitral Regurgitation (438K)|
Y.E. Kocabasoglu and R.H. Henning
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