Table of Contents Aortic regurgitationMitral stenosisWhy don’t you test your knowledge?Try some OSCE stations! Aortic regurgitation Aortic regurgitation murmur Aortic regurgitation results in regurgitation of blood from the aorta back into the left ventricle during diastole. This results in increased left ventricular end-diastolic volume. Character: Early diastolic (sounds like a breath)Best heard: upper right sternal edge (or lower left sternal edge sitting forwards); loudest on expirationRadiation: noneSymptoms: FatigueSOBPalpitationsSigns: Collapsing pulseWide pulse pressureVery displaced thrusting apex (volume-loaded)Backflow signs:Corrigan’s (visible carotid pulsation)de Musset’s (head-nodding pulse)Quincke’s (red-coloured pulsation in nails)±Austin Flint murmur (apical diastolic rumble) Causes of… Aortic regurgitation Acute causes Infective endocarditisAortic dissection Chronic causes Connective tissue disorders (e.g. Marfan syndrome, ankylosing spondylitis)Rheumatic heart diseaseLuetic heart disease (syphilis)Congenital/bicuspid aortic valveLongstanding hypertension Mitral stenosis Mitral stenosis murmur Mitral stenosis causes increased resistance between left atrium and left ventricle. This results in high left atrial pressure and subsequent pulmonary hypertension. Character: low rumbling mid-diastolic with opening snapBest heard: apex in left lateral position; loudest on expiration using bell of stethoscopeRadiation: noneSymptoms: DyspnoeaFatigueHaemoptysisChest painSigns: Malar flush (due to low cardiac output)AFTapping apex (palpable S1)Loud S1Signs of pulmonary hypertension (RV heave, loud P2) Causes of… Mitral stenosis Rheumatic heart diseaseOthers causes rare (e.g. congenital, carcinoid) Why don’t you test your knowledge? What are the causes of a wide and narrow pulse pressure? Oops! This section is restricted to members. Create an account or log in to continue reading. Subscribe Log In What is an Austin Flint murmur? Oops! This section is restricted to members. Create an account or log in to continue reading. Subscribe Log In What are the Duke criteria for infective endocarditis? Oops! This section is restricted to members. Create an account or log in to continue reading. Subscribe Log In Try some OSCE stations! Cardiovascular examinationCardiovascular examination pansystolic murmurCardiovascular examination valve replacementAortic StenosisChest Pain 1And there’s lots more here!