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The Identification of Mild Mitral Regurgitation: Its Separation from Innocent Murmurs by Intracardiac and Esophageal Phonocardiography Combined with Pharmacologic Response.

Richard F. Leighton, M.D.; William L. Page, M.D.; Richard S. Goodwin, M.S.; Charles F. Wooley, M.D.; and Joseph M. Ryan, M.D., F.A.C.P.
Ann Intern Med. 1964;61(4):797. doi:10.7326/0003-4819-61-4-797_1
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Nine patients, aged 19 to 48, with apical systolic murmurs, without radiologic or electrocardiographic evidence of cardiac enlargement, were studied. An innocent murmur was frequently suspected. All had external phonocardiograms with pharmacologic studies. Phonocardiograms were also recorded from within the esophagus at the atrial level in eight, and from within the left and right sides of the heart in five and seven patients, respectively. Right heart and pulmonary artery murmurs were thereby excluded and mitral regurgitation was diagnosed in all patients. Confirmation was obtained in three who had left ventricular angiography.

These murmurs were of high frequency and either pansystolic


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