Table I shows a breakdown of the three clinical scenarios focused on normal heart sounds, third and fourth heart sound, systolic murmurs (innocent murmur and mitral valve prolapse), and diastolic murmurs
(chronic and acute aortic regurgitation).
A short early diastolic murmur
at left 3rd intercostal space with a grade II/VI ejection systolic murmur at left 3rd intercostal space.
We detected diastolic murmur
along left sternal border on physical examination.
His chest is clear and careful cardiac examination revealed a 2/6 early diastolic murmur
in aortic region.
Physical findings such as irregular heart rhythms, any diastolic murmur
, systolic murmurs that increase with Valsalva or decrease in the supine position, and findings consistent with Marfan syndrome (Table 3) should also be treated as indicators for further cardiac workup.
On his physical examination blood pressure was 110/70 mmHg, pulse rate was 80/min and the diastolic murmur
was heard on the mesocardiac area.
Signs of right ventricular failure (edema, ascites) may be evident, and a harsh holosystolic murmur, a diastolic murmur
, tachycardia, tachypnea, thrills, polycythemia, anemia, and leukocytosis can all be detected on presentation but again are nonspecific.
A 25-year-old white man with a history of congenital aortic valve stenosis, surgically corrected at age 8, presented with fever and worsening of his diastolic murmur