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Continuous murmur is seen in all the following except-

A
Aoic sinus of valsalva rupture
B
Coarctation of Aoa
C
AV malforniations
D
Peripheral pulmonary stenosis
High-Yield Explanation
A continuous murmur is predicated ona pressure gradient that persists betweentwo cardiac chambers or blood vesselsacross systole and diastole. The murmurstypically begin in systole, envelop thesecond hea sound (S 2 ), and continuethrough some poion of diastole. Theycan often be difficult to distinguish fromindividual systolic and diastolic murmursin patients with mixed valvular hea disease.The classic example of a continuousmurmur is that associated with a patentductus aeriosus, which usually is heardin the second or third interspace at a slightdistance from the sternal border. Othercauses of a continuous murmur includea ruptured sinus of Valsalva aneurysmwith creation of an aoic-right atrialor right ventricular fistula, a coronaryor great vessel aeriovenous fistula, andan aeriovenous fistula constructed toprovide dialysis access. Ref Harrison 20th edition pg 1445

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