Austin Flint Murmur

Austin Flint murmur is detected in cases of severe aortic regurgitation. The blood jets from the aortic regurgitation strike the anterior leaflet of the mitral valve, leading to a mid-diastolic, low-pitched rumbling best heard at the cardiac apex. Austin Flint murmur due to aortic regurgitation , originating at the mitral valve when blood enters simultaneously from both the aorta and the left atrium . The patient was referred for a cardiac MRI examination to quantify aortic regurgitation and determine ventricular volumes .A55-year-old man complained of dyspnea on exertion. On examination, he had a loud parasternal diastolic murmur indicative of aortic valve regurgitation and an apical middiastolic and presystolic rumble (Austin Flint murmur).

Austin Flint murmur is a presystolic or late diastolic (mitral) heart murmur best heard at the apex of the heart. Austin Flint murmur is present in some cases of aortic insufficiency and is thought to be due to the vibration of the mitral valve caused by regurgitation of blood from the aorta into the heart before contraction of the ventricles.

Cause of Austin Flint Murmur

The main causes of Austin Flint Murmur:

• Austin Flint murmur, although the exact cause of the murmur is still not known.
• Vibration of the anterior mitral valve leaflet due to the regurgitant jet.
• Collision of the jet with mitral inflow .
• Increased mitral inflow velocity due to narrowing of the valve orifice by the jet,
• And vibration from the jet impinging on the myocardial wall.

Signs and symptoms of Austin Flint murmur

Signs and symptoms often experienced with Austin Flint murmur are:

• Sudden drop in coronary driving pressure
• Increased filling pressure of the LV
• Increased left atrial pressure
• Low cardiac output

Treatment of Austin Flint Murmur

Treatment of Austin Flint Murmur:

• At present, acute severe aortic valve insufficiency (AI) can not be managed by medications alone.
• Symptomatic patients with normal LV function may be treated safely with aggressive medical management with variable results, but no present data have provided for a significant role of medical therapy for patients with acute severe AI.
• The excess in afterload increases burden on the left side of the heart. Theoretically, any medication that can reduce afterload could be expected to improve left ventricular function and decrease regurgitant backflow from the aorta.
• This result may also be expected with the use of similar vasodilating agents.
• This would provide a temporizing measure by which surgical intervention can be postponed. One study showed that the use of nifedipine in asymptomatic patients with severe aortic regurgitation who had normal LV function could delay the need for surgery by 2-3 years.
• Arrhythmias treated when present
• Bradycardias treated when present
• Possible infections treated
• Possible role of nitroglycerin in management of angina
• Intravenous hydralazine
• Oral prazosin

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