Listen for: A low rumble at the end of diastole that runs into S1 (presystolic). Systole is clear.
Usually means: Classically mitral stenosis in sinus rhythm, where atrial contraction pushes blood through the narrow valve.
References1
- Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia: Wolters Kluwer; 2021. Cardiovascular system chapter.