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 + long diastolic murmur with presystolic accentuation.

This is a graphic example of an S1, a holosystolic murmur, a single S2 and a long diastolic murmur with presystolic accentuation. Let us listen to and observe these events together. Note that the diastolic murmur begins shortly after S2 and that it lasts throughout the rest of diastole with prominent increase in intensity just before S1.