You are incorrect - This patient's acoustic events at the apex include a first heart sound, a holosystolic murmur, a single second heart sound and a mid diastolic murmur.


Your choice: Holosystolic murmur + early diastolic murmur

This is a graphic example of an S1, a holosystolic murmur, an S2 and an early diastolic murmur. Let us listen to and observe this murmur together. Note that this high frequency diastolic murmur begins simultaneously with S2, making S2 somewhat difficult to hear. Note also that this combination of two murmurs can simulate a continuous murmur. Careful listening in all areas allows one to make this distinction.