Mitral Stenosis- rheumatic

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LISTEN WITH HEADPHONES. Recording made with a Thinklabs One Digital Stethoscope. Severe symptomatic rheumatic mitral stenosis, age 38, prior valvuloplasty 18 years ago. Resting mean gradient 6, exercise 11, MVA 1.0 cm2. Note the extra heart sound early in diastole, which is an "opening snap". Here at the apex a faint mid diastolic rumbling murmur is also present, not appreciated in the pulmonic area.

Contributor: Terry Bauch, MD, Geisinger Medical Center

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Hope this is not on my USMLE Step 1 exam tomorrow cause I have no idea what I just heard

sccm