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What is All of the following murmurs may be heard in patients with aoic regurgitation except and explain in detail?
The murmur of chronic AR is typically a high-pitched, blowing, decrescendo diastolic murmur, heard best in the third intercostal space along the left sternal border. In patients with mild AR, this murmur is brief, but as the severity increases, it generally becomes louder and longer, indeed holodiastolic. When the murmur is soft, it can be heard best with the diaphragm of the stethoscope and with the patient sitting up, leaning forward, and with the breath held in forced expiration.In patients in whom the AR is caused by primary valvular disease, the diastolic murmur is usually louder along the left than the right sternal border."Cooing" or musical diastolic murmurs suggest eversion of an aoic cusp vibrating in the regurgitant stream.A mid-systolic ejection murmur is frequently audible in isolated AR. It is generally heard best at the base of the hea and is transmitted along the carotid aeries. This murmur may be quite loud without signifying aoic obstruction.A third murmur sometimes heard in patients with severe AR is the Austin Flint murmur, a soft, low-pitched, rumbling mid-to-late diastolic murmur. It is probably produced by the diastolic displacement of the anterior leaflet of the mitral valve by the AR stream and is not associated with hemodynamically significant mitral obstruction.Ref: Harrison; 19th edition; Page no: 1536