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Recording provided by Jules Constant, MD.

Mitral Stenosis in Atrial Fibrillation
Intensity of the murmur of mitral stenosis varies with changes in length of the cardiac cycles. In this sample of atrial fibrillation, the murmur increases in intensity with longer cycles and decreases in intensity with shorter cycles, because the volume of blood flowing across the mitral valve changes. Overall intensity is decreased because atrial contraction is lost.