We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Postoperative Diastolic Murmur

D. Frank Andrews III, MC, USAF; Madhusudan Borde, MC, USAF; Babu Easow, MC, USAF
Arch Intern Med. 1982;142(5):1009-1010. doi:10.1001/archinte.1982.00340180167028.
Text Size: A A A
Published online


A 20-year-old woman was seen initially complaining of mild dyspnea after climbing two flights of stairs. She also stated she had undergone open heart surgery in April 1968.

Results of a physical examination indicated the patient was in no visible distress. Vital signs disclosed a blood pressure of 136/68 mm Hg in the right arm, with no substantial difference in the left arm. The pulse rate was regular at 76 beats per minute. Findings from the cardiovascular examination indicated normal jugular venous pulses and carotid upstroke. The point of maximal impulse was 2 cm in the fifth intercostal space at the midclavicular line. The patient was noted to have a right parasternal lift without palpable thrills. On auscultation, S1 was of normal intensity and S2 was physiologically split. A grade 1 to 2/6 midsystolic crescendo decrescendo murmur was heard best at the left third and fourth intercostal space


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.