Audible atrial flutter sound creates a strange impression of two simultaneously beating hearts in one chest cavity. It is a rare and subtle sign. Here I will show you two cases.

It is more likely to make a correct diagnosis of unfrequent disease when you remember this disease. 


A middle aged woman, apex of the heart: ...

Asymptomatic middle aged woman with some severe heart problem. Soon she had cardiac surgery. Can you make a diagnosis from this audio fragment of her heart sound:

It is simpler to make a correct diagnosis when you have an appropriate experience. If you have extensive experience, you can make the diagnosis almost automatically without any mental strain.
It 's hard to make a diagnosis when you meet some disease for the first time, especially when this disease is rare. That is why it is useful to read good descriptions of clinical cases. Here is another one challenging case.

There are two kinds of problems in heart auscultation:
- an auscultatory sign can be faint
- an auscultatory picture can be too complex

By the way, I am going to publish the book about solutions of such problems. 

Here I am going to describe a case with very faint and rare musical murmur which was very difficult to hear.  

A very loud auscultatory sign can attract our particular interest.  Especially when this sign is palpable.  Especially when this sign is visible.

Is it possible to find left atrial myxoma bedside? 


Sometimes it is possible.  But cardiac myxomas are a rare illness.  It is almost impossible to get corresponding experience auscultating a lot of such patients.  


Our patient described below had clear and bright auscultatory picture of the left atrial myxoma.  You can learn this case and probably one day you will make the correct diagnosis by auscultation alone.