Diastolic Murmurs

Mild Mitral Stenosis Lesson #688

patient thorax when auscultating by stethoscope

The patient was supine left side down during auscultation.

Description

Mild mitral stenosis murmurs can have increased intensity of S1, while the second heart sound is normal and unsplit. Systole is silent. In this recording, an opening snap occurs 100 milliseconds into diastole. As mitral stenosis becomes more severe, the opening snap will occur earlier in diastole. A diamond-shaped, low-frequency murmur follows the opening snap.

Auscultate using the stethoscope bell.

The first heart sound intensity is increased because of the mild thickening of the mitral valve leaflets. Mild mitral stenosis is commonly due to rheumatic heart disease.

In the cardiac animation, observe the turbulent blood flow from the left atrium into the left ventricle. Also, notice the minimally thickened mitral valve leaflets and the minimally enlarged left atrium.

Phonocardiogram

Anatomy

Mild Mitral Stenosis

Review the cardiac animation. You can see the turbulent blood flow from the left atrium into the left ventricle. Observe the minimally thickened mitral valve leaflets and the minimally enlarged left atrium. The excursion of the mitral valve leaflets is minimally decreased.

Authors and Sources

Authors and Reviewers

Heart sounds by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient.
Lung sounds by Diane Wrigley, PA
Respiratory cases: William French
David Lieberman, Audio Engineering
Heart sounds mentorship by W. Proctor Harvey, MD
Special thanks for the medical mentorship of Dr. Raymond Murphy
Reviewed by Dr. Barbara Erickson, PhD, RN, CCRN.
Last Update: 11/10/2021

Sources

Heart and Lung Sounds Reference Library Diane S. Wrigley
Publisher: PESI
Impact Patient Care: Key Physical Assessment Strategies and the Underlying Pathophysiology
Diane S Wrigley & Rosale Lobo
Practical Clinical Skills: Lung Sounds
Essential Lung Sounds Diane S. Wrigley, PA-C
Published by MedEdu LLC
PESI Faculty - Diane S Wrigley
Case Profiles in Respiratory Care 3rd Ed, 2019
William A.French
Published by Delmar Cengage
Essential Lung Sounds by William A. French
Published by Cengage Learning, 2011
Understanding Lung Sounds Steven Lehrer, MD
Clinical Heart Disease W Proctor Harvey, MD
Clinical Heart Disease
Laennec Publishing; 1st edition (January 1, 2009)
Heart and Lung Sounds Reference Guide
PracticalClinicalSkills.com