What is the significance of a diastolic rumble in mitral regurgitation ? It signifies the presence of' coexistent mitral stenosis. In the absence of mitral stenosis it suggests that there is high diastolic transmitral flow and severe mitral regur-gitation. Inhalation of amyl nitrate increases both the duration and intensity of the diastolic murmur due to mitral stenosis whereas it decreases them if the diastolic rumble is caused solely by mitral regurgitation. Also the presence of an opening snap suggests mitral stenosis as the cause of the diastolic rumble.
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