<prompt> A continuous murmur is heard in all of the following conditions exceptVentricular septal defect with aoic regurgitationPatent ductus aeriosusCoronary aeriovenous fistulaVenous hum  <response>: A continuous murmur is predicated on a pressure gradient that persists between two cardiac chambers or blood vessels across systole and diastole. The murmurs typically begin in systole, envelop the second hea sound S2 , and continue through some poion of diastole.They can often be difficult to distinguish from individual systolic and diastolic murmurs in patients with mixed valvular hea disease.The classic example of a continuous murmur is that associated with a PDA, which usually is heard in the second or thirdinterspace at a slight distance from the sternal border. Other causes of a continuous murmur include a ruptured sinus of Valsalva aneurysm with the creation of an aoic-right atrial or right ventricular fistula, a coronary or great vessel aeriovenous fistula, and an aeriovenous fistula constructed to provide dialysis accessRef: Harrisons 18e p1829 