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The exact cause of an Austin Flint murmur is unknown. Hypothesis is that the mechanism of murmur is from the severe aortic regurgitation. In severe aortic regurgitation the jet vibrates the anterior mitral valve leaflet. This causes collision with the mitral inflow during diastole. As such, the mitral valve orifice narrows.
The first heart sound, or S 1, forms the "lub" of "lub-dub" and is composed of components M 1 (mitral valve closure) and T 1 (tricuspid valve closure). Normally M 1 precedes T 1 slightly. It is caused by the closure of the atrioventricular valves , i.e. tricuspid and mitral (bicuspid), at the beginning of ventricular contraction, or systole .
The mitral valve in cases of mitral stenosis may open with an opening snap [1] [2] on the beginning of diastole. Patients with mitral valve prolapse may have a mid-systolic click along with a murmur, referred to as apical late systolic murmur. [3] Early systolic clicks may also be present in some patients. [4]
The Austin Flint murmur is named after the 19th century American physician, Austin Flint (1812–1886). [8] He disapproved of associating any physical sign with the name of the original describer, and wrote, "So long as signs are determined from fancied analogies, and named from these or after the person who describes them, there cannot but be obscurity and confusion."
Mitral regurgitation, also known as mitral insufficiency or mitral incompetence, is the backward flow of blood from the left ventricle, through the mitral valve, and into the left atrium, when the left ventricle contracts, resulting in a systolic murmur radiating to the left armpit.
The mitral valve is typically 4 to 6 square centimetres (0.62 to 0.93 sq in) in area and sits in the left heart between the left atrium and the left ventricle. [5] It has two cusps: an anterior one, and a posterior one. [6] The opening of the mitral valve is surrounded by a fibrous ring known as the mitral annulus. The anterior cusp attaches to ...
Mitral valve prolapse: This is the most common cause of late systolic murmurs. It can be heard best over the apex of the heart, usually preceded by clicks. The most common cause of mitral valve prolapse is "floppy" valve (Barlow's) syndrome. If the prolapse becomes severe enough, mitral regurgitation may occur.
diastolic murmurs (e.g. aortic regurgitation, mitral stenosis) systolic murmurs (e.g. aortic stenosis, mitral regurgitation) pericardial rub (suggestive of pericarditis) The base of the lungs should be auscultated for signs of pulmonary oedema due to a cardiac cause such as bilateral basal crepitations.