Abstract
An apical diastolic rumble often appears during the first episode of active rheumatic fever within the first week of the illness. It is associated with an abnormal apical systolic murmur due to mitral regurgitation. Since mitral stenosis takes months or years to develop, such a diastolic murmur should not be regarded as being due to mitral stenosis. Various theories were advanced about the origin of the murmur. We have explained it as being due to dilatation of the left ventricle. The disappearance of the murmur within a few weeks coincides with the improvement of the patient's condition, and with the disappearance of the other clinical and laboratory signs of rheumatic activity. The phonocardiographic tracings of two cases demonstrate the mid-diastolic murmur, which appeared early in the disease and subsequently disappeared.
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