Mitral Stenosis
Mitral stenosis causes a low pitched, rumbling, diastolic murmur after the opening snap that continues through diastole and gets louder (presystolic accentuation) just before S1 due to atrial contraction best heard with the bell at the apex.
Patient 1:
This is a young woman who grew up in Mexico and presented with a transient ischemic attack, severe flank pain from a renal embolism, and hemoptysis. She was found to have severe mitral stenosis. Note the loud S1, opening snap, and rumbling diastolic murmur with presystolic accentuation.
Audio recording courtesy of BMJ case reports: “Mitral Stenosis”
Mitral Stenosis
Annotated
Mitral Stenosis
Annotated