Which of the auscultatory sign is absent in mitral stenosis in the presence of atrial fibrillation?
The presystolic accentuation of the mid-diastolic murmur of atrial fibrillation is due to atrial contraction against a closed mitral valve. With the onset of atrial fibrillation, since atrial will be twitching, pre-systolic accentuation will disappear. Other changes in findings of mitral stenosis with an onset of atrial fibrillation are: The first hea sound becomes variable in intensity as hea rhythm is irregularly irregular Opening snap continues to occur as long as the valves are pliable and non-calcified. Length of the diastolic murmur varies.
Mid diastolic murmur
Presystolic accentuation
Variable first hea sound
Loud P2
Rheumatic Hea disease & infective endocarditis