What is the clinical evidence from this study?

Study design: Case Report. Population: Mitral insufficiency simulating aortic stenosis (n=2). Intervention: Left heart catheterization and phonocardiography. Primary outcome: Diagnosis of mitral insufficiency without aortic stenosis.

What does this research mean for the field?

Mitral insufficiency can produce loud systolic murmurs and thrills in the aortic area that closely simulate aortic stenosis. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To describe the mechanism and clinical presentation of mitral insufficiency that produces loud murmurs and thrills mimicking aortic stenosis.

August 17, 2026CirculationOpen Access

Mitral Insufficiency Simulating Aortic Stenosis

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Key result

Mitral insufficiency mimics aortic stenosis by causing loud aortic area systolic murmurs and thrills.

Design

Case series

Authors

JSJulian C. SleeperDuke Medical Center EOEdward S. OrgainDuke University HMHenry D. McIntoshAmerican College of Cardiology

Discussion

Member takes

Implication

Mitral insufficiency may mimic aortic stenosis murmurs; leaves open the diagnostic utility of phonocardiography in ambiguous cases.

Key Points

To describe the mechanism and clinical presentation of mitral insufficiency that produces loud murmurs and thrills mimicking aortic stenosis.
Evaluated 2 patients presenting with loud systolic murmurs and thrills in the aortic area using left heart catheterization to assess valve gradients and shunt presence.
Performed phonocardiography to analyze the timing and acoustic characteristics of the aortic area murmurs.
Left heart catheterization confirmed severe mitral insufficiency without evidence of aortic stenosis or intracardiac shunts such as ventricular septal defects.
Phonocardiography revealed holosystolic murmur profiles that established the mitral origin of the sounds transmitted to the aortic area.
A regurgitant jet striking the left atrial wall adjacent to the aortic valve was identified as the primary physical mechanism of the aortic thrill and murmur.

Study Design

Type

Case Report (n=2)

Structured PICO

Population

Two patients with mitral insufficiency presumably secondary to rheumatic heart disease presenting with loud systolic murmurs and thrills in the aortic area.

Exposure

Diagnostic evaluation including left heart catheterization and phonocardiography

Outcome

Diagnosis of mitral insufficiency without aortic stenosis or intracardiac shunt

Mitral insufficiency can present with loud systolic murmurs and thrills in the aortic area simulating aortic stenosis, which can be differentiated using phonocardiography and left heart catheterization.

Cite This Study

Sleeper et al. (1962) conducted a case report in Mitral insufficiency simulating aortic stenosis (n=2). Left heart catheterization and phonocardiography was evaluated on Diagnosis of mitral insufficiency without aortic stenosis. In two patients, loud systolic murmurs and thrills in the aortic area simulating aortic stenosis were documented by left heart catheterization and phonocardiography to be caused by mitral insufficiency.

synapsesocial.com/papers/6a832683bd1fa53dac83828d https://doi.org/10.1161/01.cir.26.3.428

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Mitral Insufficiency Simulating Aortic Stenosis

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Mitral Insufficiency Simulating Aortic Stenosis

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Also Consider