A continuous murmur is heard in all of the following conditions except-
Correct Answer: Ventricular septal defect with aoic regurgitation
Description: A continuous murmur is predicated on a pressure gradient that persists between two cardiac chambers or blood vessels across systole and diastole. The murmurs typically begin in systole, envelop the second hea sound (S 2 ), and continue through some poion of diastole. They can often be difficult to distinguish from individual systolic and diastolic murmurs in patients with mixed valvular hea disease. The classic example of a continuous murmur is that associated with a patent ductus aeriosus, which usually is heard in the second or third interspace at a slight distance from the sternal border. Other causes of a continuous murmur include a ruptured sinus of Valsalva aneurysm with creation of an aoic-right atrial or right ventricular fistula, a coronary or great vessel aeriovenous fistula, and an aeriovenous fistula constructed to provide dialysis access. Harrison's principle of internal medicine,20edition,pg no.1556
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