academic question

[ermengarde]

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I saw a patient today with a long-standing history of MS treated by valvotomy in the past and recent MVR. When I examined him the diastolic rumbling murmur was present in addition to the mechanical 1st heart sound at the apex.

Is it normal for the murmur to be heard after surgical treatment? If yet what is the underlying mechanism? Or were my ears hallucinating?

Thanks.