Figure 199h

The apex phonocardiogram is recorded simultaneously with the mitral valve echocardiogram in a patient with acute aortic regurgitation. There is middiastolic preclosure of the mitral valve,and a very soft S1 is recorded coincident with the terminal closing motion of the mitral valve following the onset of ventricular systole. A systolic ejection murmur (SEM) is present during systole, and an Austin Flint murmur is introduced by and S3 gallop during early diastole. Note the absence of the presystolic component of the Austin Flint murmur.