# During auscultation, the nurse hears a loud ______ sound immediately after S2, suggesting possible aortic regurgitation.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=168389  
> language: ko  
> subject: Diseases of the circulatory system

## 문제

During auscultation, the nurse hears a loud ______ sound immediately after S2, suggesting possible aortic regurgitation.

## 보기

1. diastolic **✔ 정답**
2. systolic
3. continuous
4. splitting
5. friction

**정답: 1**

## 해설

A diastolic murmur occurring immediately after S2 is characteristic of aortic regurgitation. This high-pitched, blowing sound is caused by blood flowing backward through an incompetent aortic valve during diastole.

## 임상 시나리오

Aortic Regurgitation (AR):
- Early diastolic decrescendo murmur
- Best heard at left sternal border, 3rd/4th intercostal space
- Associated symptoms: wide pulse pressure, water-hammer pulse
- Causes: endocarditis, rheumatic fever, aortic root dilation
- Austin Flint murmur: mid-diastolic rumble in severe AR
- Physical findings: head bobbing, Corrigan's pulse, pistol-shot sounds
- ECG changes: left ventricular hypertrophy
- Complications: left ventricular failure
- Treatment options: valve replacement, medical management
- Diagnostic tests: echocardiogram, cardiac catheterization
- Risk factors: hypertension, connective tissue disorders
- Grading: mild, moderate, severe based on regurgitant fraction
- Prevention: endocarditis prophylaxis in high-risk patients

## 핵심 개념

- **diastolic** — Relating to or occurring during diastole, when the heart muscle relaxes and the chambers fill with blood
- **systolic** — Relating to or occurring during systole, when the heart muscle contracts to pump blood out
- **continuous** — A heart sound that occurs throughout both systole and diastole without interruption
- **splitting** — The separation of normal heart sounds into two distinct components
- **friction** — A scratching or grating sound caused by inflammation of the pericardium, resulting in rubbing between its layers

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