Austin Flint Murmur.

Abstract

Please find supplementary file(s); http://dx.doi.org/10.1253/circj.CJ-18-0697 A 73-year-old man with a history of hypertension was referred to hospital because of a heart murmur and an abnormal electrocardiogram (right bundle branch block and left ventricular [LV] hypertrophy) on medical checkup. On physical examination, a systolic ejection murmur and an early diastolic murmur were heard at the base of the heart, whereas the cardiac apex showed a diastolic rumble (Movie S1). Phonocardiography (Figure A) demonstrated systolic ejection murmurs in the high (H) and higher-middle (M2) frequency ranges (arrowhead) after the first sound (S1); of note, diastolic rumbling was recorded in the low (L) and lower-middle (M1) frequency ranges (arrows) after the second sound (S2). A diagnosis of severe aortic regurgitation, along with mild aortic stenosis, was made on echocardiography (Figure B; Table S1). The low-pitched diastolic rumble at the apex is known as the Austin Flint murmur,1 a sign of severe aortic regurgitation that needs to be treated. Proposed mechanisms for this condition include vibration Received July 9, 2018; revised manuscript received August 20, 2018; accepted September 7, 2018; released online October 4, 2018 Time for primary review: 28 days Department of Cardiology, Matsushita Memorial Hospital, Moriguchi, Japan Mailing address: Nozomi Yoshioka, MD, Department of Cardiology, Matsushita Memorial Hospital, 5-55 Sotojima, Moriguchi 570-8540, Japan. E-mail: [email protected] ISSN-1346-9843 All rights are reserved to the Japanese Circulation Society. For permissions, please e-mail: [email protected] Austin Flint Murmur