{"id":3182,"date":"2020-05-27T21:28:46","date_gmt":"2020-05-28T04:28:46","guid":{"rendered":"https:\/\/up.physicaldiagnosispdx.com\/up\/?page_id=3182"},"modified":"2021-12-21T12:25:19","modified_gmt":"2021-12-21T20:25:19","slug":"aortic-regurgitation-2","status":"publish","type":"page","link":"https:\/\/up.physicaldiagnosispdx.com\/up\/cardiology-multimedia-new\/aortic-regurgitation-2\/","title":{"rendered":"Aortic Regurgitation"},"content":{"rendered":"<div class=\"wpb-content-wrapper\">[vc_row css=&#8221;.vc_custom_1591998245346{background-color: #fff9f9 !important;}&#8221;][vc_column][vc_column_text]\n<ul>\n<li><span style=\"font-size: 14pt;\">Soft, decrescendo murmur that starts right at S2 and trails off (turbulence is highest in early diastole when the pressure gradient between the aorta and LV is highest).<\/span><\/li>\n<li><span style=\"font-size: 14pt;\">Murmur may be best heard with the patient leaning forward, holding their breath after a full exhalation.<\/span><\/li>\n<li><span style=\"font-size: 14pt;\">This murmur is classically associated with a wide pulse pressure, due to the larger than normal cardiac output (blood coming from both the left atrium and the blood leaking back from the aorta). The diastolic pressure is lower as blood is running off in both directions, and the vasculature peripherally is open to accommodate the increased forward flow (autoregulation). This causes the classic water hammer pulse, which can be felt in the radial pulse, and the Corrigan\u2019s pulse (a large, bounding carotid pulse)<\/span><\/li>\n<\/ul>\n<p><a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/cardiology-2\/card-tutorial\/#Aortic_Regurgitation\"><img decoding=\"async\" loading=\"lazy\" class=\"alignnone wp-image-1658 size-thumbnail\" src=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308-150x150.png\" alt=\"\" width=\"150\" height=\"150\" srcset=\"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308-150x150.png 150w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308-300x300.png 300w, https:\/\/up.physicaldiagnosispdx.com\/up\/wp-content\/uploads\/iconfinder_3_1250308.png 512w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/a>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n<h1 id=\"patient1\">Patient 1:<\/h1>\n<p><span style=\"font-size: 14pt;\">This is a middle-aged woman with a history of thoracic aortic aneurysm complicated by a type A dissection status-post valve-sparing aortic root replacement, who has subsequently developed moderate to severe aortic regurgitation. Note the presence of a systolic murmur in addition to the long decrescendo diastolic murmur. The systolic murmur is a &#8220;flow&#8221; murmur related to the increased volume of blood moving through the aortic valve with every beat<\/span><\/p>\n<div class=\"vc_row wpb_row vc_row-fluid\">\n<div class=\"wpb_column vc_column_container vc_col-sm-12\">\n<div class=\"vc_column-inner\">\n<div class=\"wpb_wrapper\">\n<div class=\"wpb_text_column wpb_content_element \">\n<div class=\"wpb_wrapper\"><span style=\"font-size: 14pt;\">This patient also has <a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/cardiology-2\/cardiology-multimedia-new\/corrigans-pulse\/#patient2\" target=\"_blank\" rel=\"noopener noreferrer\">Corrigan&#8217;s pulse<\/a> and Quincke\u2019s pulse.<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n[\/vc_column_text][vc_column_text][\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1591998266057{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><span style=\"font-size: 18pt;\"><strong>Aortic Regurgitation<\/strong><\/span><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/463370302?loop=1 \" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">&amp;amp;amp;lt;span data-mce-type=&#8221;bookmark&#8221; style=&#8221;display: inline-block; width: 0px; overflow: hidden; line-height: 0;&#8221; class=&#8221;mce_SELRES_start&#8221;&amp;amp;amp;gt;\ufeff&amp;amp;amp;lt;\/span&amp;amp;amp;gt;<\/iframe>[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><span style=\"font-size: 18pt;\"><strong>Annotated<\/strong><\/span><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/463372241?loop=1 \" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">&amp;lt;span data-mce-type=&#8221;bookmark&#8221; style=&#8221;display: inline-block; width: 0px; overflow: hidden; line-height: 0;&#8221; class=&#8221;mce_SELRES_start&#8221;&amp;gt;\ufeff&amp;lt;\/span&amp;gt;<\/iframe>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1591998266057{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Aortic Regurgitation<\/span><\/strong><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/463371057?loop=1 \" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">&amp;lt;span data-mce-type=&#8221;bookmark&#8221; style=&#8221;display: inline-block; width: 0px; overflow: hidden; line-height: 0;&#8221; class=&#8221;mce_SELRES_start&#8221;&amp;gt;\ufeff&amp;lt;\/span&amp;gt;<\/iframe>[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Annotated<\/span><\/strong><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/463372792?loop=1 \" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">&amp;lt;span data-mce-type=&#8221;bookmark&#8221; style=&#8221;display: inline-block; width: 0px; overflow: hidden; line-height: 0;&#8221; class=&#8221;mce_SELRES_start&#8221;&amp;gt;\ufeff&amp;lt;\/span&amp;gt;<\/iframe>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n<h1 id=\"patient2\">Patient 2:<\/h1>\n<p><span style=\"font-size: 14pt;\">This is an older man with an aortic root aneurysm complicated by moderate to severe aortic regurgitation. <\/span><\/p>\n<p><span style=\"font-size: 14pt;\">This patient also has <a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/cardiology-2\/cardiology-multimedia-new\/corrigans-pulse\/#patient1\" target=\"_blank\" rel=\"noopener noreferrer\">Corrigan&#8217;s pulse<\/a>, <a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/cardiology-2\/cardiology-multimedia-new\/bounding-pulse\/#patient3\" target=\"_blank\" rel=\"noopener noreferrer\">a bounding peripheral pulse<\/a>, <a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/cardiology-2\/cardiology-multimedia-new\/pulsus-bisferiens\/#patient1\" target=\"_blank\" rel=\"noopener noreferrer\">bisferiens pulse<\/a>, and <a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/cardiology-2\/cardiology-multimedia-new\/de-mussets-sign\/#patient1\" target=\"_blank\" rel=\"noopener noreferrer\">de Musset&#8217;s sign.<\/a><\/span>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1591998279435{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Aortic Regurgitation<\/span><\/strong><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/463370763?loop=1 \" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">&amp;lt;span data-mce-type=&#8221;bookmark&#8221; style=&#8221;display: inline-block; width: 0px; overflow: hidden; line-height: 0;&#8221; class=&#8221;mce_SELRES_start&#8221;&amp;gt;\ufeff&amp;lt;\/span&amp;gt;<\/iframe>[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Annotated<\/span><\/strong><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/463372516?loop=1 \" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">&amp;lt;span data-mce-type=&#8221;bookmark&#8221; style=&#8221;display: inline-block; width: 0px; overflow: hidden; line-height: 0;&#8221; class=&#8221;mce_SELRES_start&#8221;&amp;gt;\ufeff&amp;lt;\/span&amp;gt;<\/iframe>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1591998279435{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Aortic Regurgitation<\/span><\/strong><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/463370549?loop=1 \" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">&amp;lt;span data-mce-type=&#8221;bookmark&#8221; style=&#8221;display: inline-block; width: 0px; overflow: hidden; line-height: 0;&#8221; class=&#8221;mce_SELRES_start&#8221;&amp;gt;\ufeff&amp;lt;\/span&amp;gt;<\/iframe>[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Annotated<\/span><\/strong><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/463372330?loop=1 \" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">&amp;lt;span data-mce-type=&#8221;bookmark&#8221; style=&#8221;display: inline-block; width: 0px; overflow: hidden; line-height: 0;&#8221; class=&#8221;mce_SELRES_start&#8221;&amp;gt;\ufeff&amp;lt;\/span&amp;gt;<\/iframe>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n<h1 id=\"patient3\">Patient 3:<\/h1>\n<p><span style=\"font-size: 14pt;\">This is a young man with intravenous drug use who was admitted to the hospital with infective endocarditis of the aortic valve resulting in severe aortic regurgitation. <\/span><\/p>\n<p><span style=\"font-size: 14pt;\">This patient also has an <a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/cardiology-2\/cardiology-multimedia-new\/aortic-regurgitation-2\/aortic-regurgitation-austin-flint-murmur\/#patient1\" target=\"_blank\" rel=\"noopener noreferrer\">Austin Flint murmur over the apex<\/a>, <a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/cardiology-2\/cardiology-multimedia-new\/bounding-pulse\/#patient1\" target=\"_blank\" rel=\"noopener noreferrer\">bounding peripheral pulses<\/a>, and <a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/pulmonology\/pulmonology-m\/cheyne-stokes-respiration\/#patient2\" target=\"_blank\" rel=\"noopener noreferrer\">Cheyne-Stokes respirations<\/a>.<\/span>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1591998296965{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><span style=\"font-size: 18pt;\"><strong>Aortic Regurgitation<\/strong><\/span><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/463370869?loop=1 \" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">&amp;lt;span data-mce-type=&#8221;bookmark&#8221; style=&#8221;display: inline-block; width: 0px; overflow: hidden; line-height: 0;&#8221; class=&#8221;mce_SELRES_start&#8221;&amp;gt;\ufeff&amp;lt;\/span&amp;gt;&amp;amp;lt;span data-mce-type=&#8221;bookmark&#8221; style=&#8221;display: inline-block; width: 0px; overflow: hidden; line-height: 0;&#8221; class=&#8221;mce_SELRES_start&#8221;&amp;amp;gt;\ufeff&amp;amp;lt;\/span&amp;amp;gt;<\/iframe>[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Annotated<\/span><\/strong><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/463372612?loop=1 \" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">&amp;lt;span data-mce-type=&#8221;bookmark&#8221; style=&#8221;display: inline-block; width: 0px; overflow: hidden; line-height: 0;&#8221; class=&#8221;mce_SELRES_start&#8221;&amp;gt;\ufeff&amp;lt;\/span&amp;gt;<\/iframe>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n<h1 id=\"patient4\">Patient 4:<\/h1>\n<p><span style=\"font-size: 14pt;\">This is a middle-aged man with active intravenous drug use who was found to have infective endocarditis of the aortic valve resulting in destruction of the non-coronary cusp of the aortic valve and severe aortic regurgitation. In addition to the diastolic and systolic murmurs, there is an extra transient sound near S1, likely an ejection click.<\/span><\/p>\n<p><span style=\"font-size: 14pt;\">This patient also has <a href=\"https:\/\/up.physicaldiagnosispdx.com\/up\/cardiology-2\/cardiology-multimedia-new\/aortic-regurgitation\/#patient1\" target=\"_blank\" rel=\"noopener noreferrer\">Traube&#8217;s sign.<\/a><\/span>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1591998310736{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Aortic Regurgitation<\/span><\/strong><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/463370944?loop=1 \" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe>[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Annotated<\/span><\/strong><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/463372698?loop=1 \" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\">&amp;lt;span data-mce-type=&#8221;bookmark&#8221; style=&#8221;display: inline-block; width: 0px; overflow: hidden; line-height: 0;&#8221; class=&#8221;mce_SELRES_start&#8221;&amp;gt;\ufeff&amp;lt;\/span&amp;gt;<\/iframe>[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n<h1>Patient 5:<\/h1>\n<p><span style=\"font-size: 14pt;\">This is a middle-aged man with Marfan\u2019s syndrome complicated by severe aortic regurgitation. There is also a split S1 from a right bundle branch block.<\/span>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1592017173859{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Aortic Regurgitation\u00a0<\/span><\/strong><\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/620891309?loop=1\" width=\"640\" height=\"564\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" data-mce-type=\"bookmark\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><strong><span style=\"font-size: 18pt;\">Annotated<\/span><\/strong><\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/620890771?loop=1\" width=\"640\" height=\"564\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" data-mce-type=\"bookmark\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n<h1>Patient 6:<\/h1>\n<p><span style=\"font-size: 14pt;\">This is an older man with severe aortic regurgitation from infective endocarditis.\u00a0<\/span><\/p>\n<p><span style=\"font-size: 14pt;\">This patient also has an Austin Flint murmur and pitting edema.<\/span>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1592017173859{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/651760846?loop=1\" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" data-mce-type=\"bookmark\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/651762302?loop=1\" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" data-mce-type=\"bookmark\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1592017173859{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/651760954?loop=1\" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" data-mce-type=\"bookmark\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/651762338?loop=1\" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" data-mce-type=\"bookmark\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1592017173859{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/651760994?loop=1\" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" data-mce-type=\"bookmark\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/651762371?loop=1\" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" data-mce-type=\"bookmark\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]\n<h1>Patient 7:<\/h1>\n<p><span style=\"font-size: 14pt;\">This is a middle aged man admitted with alcohol withdrawal. Incidental findings on cardiac exam. Extra heart sound near S1 over base and LLSB, 1\/4 decrescendo diastolic murmur over Erb&#8217;s point. ECHO showed severely dilated aortic root and ascending aorta with moderate AR.\u00a0<\/span><\/p>\n<p>&nbsp;[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1592017173859{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/652053032?loop=1\" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" data-mce-type=\"bookmark\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/652276785?loop=1\" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" data-mce-type=\"bookmark\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=&#8221;.vc_custom_1592017173859{background-color: #dcd9dd !important;}&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/652053088?loop=1\" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" data-mce-type=\"bookmark\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n[\/vc_column_text][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text]\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/652276746?loop=1\" width=\"640\" height=\"291\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" data-mce-type=\"bookmark\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n[\/vc_column_text][\/vc_column][\/vc_row]\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row css=&#8221;.vc_custom_1591998245346{background-color: #fff9f9 !important;}&#8221;][vc_column][vc_column_text] Soft, decrescendo murmur that starts right at S2 and trails off (turbulence is highest in early diastole when the pressure gradient between the aorta and LV is highest). Murmur may be best heard with the patient leaning forward, holding their breath after a full exhalation. This<\/p>\n","protected":false},"author":9,"featured_media":0,"parent":3164,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-templates\/page_PDXPDX-full-width.php","meta":{"nf_dc_page":"","_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"_lmt_disableupdate":"no","_lmt_disable":"","footnotes":""},"class_list":["post-3182","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/3182","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/users\/9"}],"replies":[{"embeddable":true,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/comments?post=3182"}],"version-history":[{"count":11,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/3182\/revisions"}],"predecessor-version":[{"id":10951,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/3182\/revisions\/10951"}],"up":[{"embeddable":true,"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/pages\/3164"}],"wp:attachment":[{"href":"https:\/\/up.physicaldiagnosispdx.com\/up\/wp-json\/wp\/v2\/media?parent=3182"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}