Summary of History and Physical - Discussion

Aortic Regurgitation

The key to defining the diagnosis of aortic regurgitation in our patient was the recognition of the classic diastolic decrescendo murmur. We’ve also defined the severity by the company it keeps, including the non-auscultatory elements of the bedside examination and the recognition of two additional murmurs. These include the early systolic flow murmur across the aortic valve and the diastolic Austin-Flint murmur at the apex.

Differential Diagnosis of Low Frequency Apical Diastolic Murmur

The differential diagnosis of a low-frequency apical diastolic murmur include the murmur of mitral stenosis, the flow murmurs of significant mitral regurgitation and shunt lesion, and the Austin-Flint murmur of significant aortic regurgitation. The interpretation of the murmur depends on both the findings on auscultation and the company it keeps with the remainder of the physical examination.