Figure 44c

Phonocardiogram with carotid pulse tracing and M-mode echocardiogram in mitral stenosis. A. The first heart sound is loud; and opening snap (OS) occurs 0.11 s after the second heart sound; the snap is followed by a low-frequency mid-diastolic murmur (MDM). B. The echophonocardiogram (slower paper speed: 50mm/s) illustrates the relation between mitral closure and the first heart sound; the opening snap occurs at the termination of the opening movement of the leaflets.

(Courtesy of Dr. Ernest Craige.) Gaasch, W.H., MD, O'Rourke, R.A., MD, Cohn, L.H., MD, Rackley, C.E., MD, Mitral Valve Disease, Hurst's The Heart, 8th edition, p 1485.