Mitral commissurotomy
by Franklin B Saksena, Ranganathan Narasimhan, Sivaciyan Vahe

The Art and Science of Cardiac Physical Examination (With Heart Sounds, Jugular and Precordial Pulsations)

by Narasimhan Ranganathan, Vahe Sivaciyan, Franklin B Saksena
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This is a recording from a patient who has had a mitral commissurotomy for mitral stenosis. The recording is from the 3rd left interspace. The S1 is not very loud like one would hear in significant mitral stenosis. One can also hear what sounds like a wide split S2. However with inspiration, intermittently one can clearly hear a trill (a triple sound). This will confirm in fact that there is an OS. Mitral commissurotomy does not necessarily get rid of the OS, although when the obstruction is significantly relieved, one will lose the diastolic murmur of mitral stenosis.

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