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Medicine C.V.S a9f2a3ed

All of the following murmurs may be heard in patients with aoic reugurgitation except -

A
High-pitched decrescendo diastolic murmur
B
Soft, low pitched middiastolic rumbling murmur
C
Mid-systolic ejection flow murmur
D
Presystolic murmur
High-Yield Explanation
S 1 is generally absent, soft, or buried in the holosystolic murmur of chronic MR. A low-pitched S 3 occurring 0.12-0.17 s after the aoic valve closure sound,It may be followed by a sho, rumbling, mid-diastolic murmur, even in the absence of structural MS. A presystolic murmur is not ordinarily heard with isolated MR. A systolic murmur of at least grade III/VI intensity is the most characteristic auscultatory finding in chronic severe MR. It is usually holosystolic, but as previously noted it is decrescendo and ceases in mid- to late systole in patients with acute severe MR. ( Harrison&;s principle of internal medicine,18th edition,pg no. 1935)

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