A systolic murmur is a common presentation of aortic regurgitation detected by echocardiography

The clinical investigation of Heidenreich et al. 1 recognizing a systolic murmur as a common presentation of aortic regurgitation invites two comments. The authors find a "high prevalence" of the murmur in contradistinction to its "rare" inclusion as a physical sign of the disorder. This is quite erroneous. A systolic murmur is known to be always present in aortic regurgitation and this was emphasized in the first and unquestionably best description of the disease by Corrigan in 1832. 2 His paper quite remarkably details the symptoms, the sign of the bounding pulse (which subsequently bore his name), the murmur heard best at the base and into the carotid and subclavian arteries, and the accompanying thrill. Corrigan only gave passing acknowledgment to the regurgitant murmur, ascribing it to the more severe insufficiency, but paid particular attention to the ejection murmur and the ways of differentiating the murmur-related diagnosis from aortic stenosis, mitral regurgitation, and ascending aortic aneurysm, by observation of other clinical signs. He also explained the mechanism of the findings and reported an experiment, published in the Lancet, reproducing the murmur and the thrill in a bench model of insufficiency, 175 years before Heidenreich's similar explanation.