In aortic regurgitation (AR) 3 types of murmurs are found.
📌 Early diastolic murmur
📌 Mid diastolic murmur
📌 Systolic flow murmur
📘 Explanation
At first we have to know the normal sequences of events of diastole for left ventricle.
📌 Step-1: at first aortic valve closes.
📌 Step-2: then LV begins to dilate.
📌 Step-3: then mitral valve opens
📌 Step-4: then blood enters into LV from LA
Nornally this is not happened. Because aortic valve tightly closes at the starting of diastole of LV.
❇️ Early diastolic murmur
In case of AR, aortic valve can not close tightly during starting of LV diastole. Thats why some blood backwardly enters into LV from aorta at this time. This blood flow produces early diasyolic murmur. As the event occurs in early stage of LV diastole that's why the murmur is early diastolic.
❇️ Mid diastolic murmur
We know that, during LV diastole at first aortic valve closes. Then mitral valve begins to open. But as in AR, aortic valve doesn’t close completely thats why some blood backwardly enters into LV. Due to this jet of blood, mitral valve can not open completely. Thats why another murmur is produced. As this event occurs at mid stage of LV diastole, thats why the murmur is mid diastolic.
❇️ Systolic flow mumur
In case of AR, during diastole of LV an extra amount of blood backwardly enters into LV from aorta. So, EDV end diastolic volume) becomes more than usual. So, stroke volume becomes more than usual. As an extra volume of blood ejects out from LV through aortic valve that's why a flow murmur occurs. As this event occurs during LV systole that's why it is called systolic flow murmur.
Dr. Muhammad Mosleh Uddin
MBBS (CMC), FCPS part-2 (Cardiology)
Chittagong Medical College & Hospital
Social links:
FB page: https://www.facebook.com/Mosleh.cmc59
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