Late diastolic murmurs occur after atrial contraction and typically represent atrioventricular valve stenosis. An example is the presystolic murmur of mitral stenosis in a patient in sinus rhythm. Let us listen to and observe diastole at the apex in a patient with mitral stenosis. Note that the murmur is late diastolic and that it occurs after atrial contraction, which follows the P wave of the electrocardiogram.