Which of the auscultatory sign is absent in mitral stenosis in the presence of atrial fibrillation?
Mid diastolic murmur
Presystolic accentuation
Variable first hea sound
Loud P2
The presystolic accentuation of the mid-diastolic murmur of atrial fibrillation is due to atrial contraction against a closed mitral valve. With the onset of atrial fibrillation, since atrial will be twitching, pre-systolic accentuation will disappear. Other changes in findings of mitral stenosis with an onset of atrial fibrillation are: The first hea sound becomes variable in intensity as hea rhythm is irregularly irregular Opening snap continues to occur as long as the valves are pliable and non-calcified. Length of the diastolic murmur varies.
Rheumatic Hea disease & infective endocarditis