Normal Heart Sound - Normal Heart Sound showing S1 and S2. No audible murmurs.

Contributed by Thinklabs Medical.

Aortic Regurgitation - Murmur best heard with patient sitting forward, Stethoscope in bell mode positioned over the second intercostal space to the right of right of the sternal border, or over the 3rd - 4th intercostal space just to the left of the sternal border. Murmur is enhanced during expiration.

Note that the aortic component of the second heart sound is soft. The characteristic murmur is an early diastolic murmur. The intensity is loudest at the onset of diastole and becomes softer during diastole - the so-called "decrescendo" murmur.

Contributed by Dr. Darryl A Smith FCP (SA) Cardiology

Aortic Regurgitation with Ejection Systolic Mumur

The stethoscope is positioned towards the left sternoclavicular junction. Note in this recording the ejection systolic murmur early in systole. The aortic regurgitant murmur is less prominent in this position. Patients with aortic valvular disease may have concomitant aortic stenosis and aortic regurgitation, or may have isolated aortic regurgitation. This patient had isolated aortic regurgitation.

The incompetent valve allows blood to re-enter the left ventricle, which results in an increased volume of blood being ejected during the subsequent beat. The increased volume of blood ejected during systole creates an audible ejection systolic murmur.

Contributed by Dr. Darryl A Smith FCP (SA) Cardiology

Aortic Stenosis, Severe - Systolic Murmur. Harsh blowing sound, crescendo / decrescendo during systole, followed by S2. Recording Note: Diaphragm mode recording 0-14 sec. followed by Bell Mode recording 14-29 sec. with increase in S2 due to greater low frequency sensitivity in Bell mode.



Contributed by Division of Cardiology, Emory University School of Medicine.