Diastolic murmurs due to two sequelae of atherosclerotic coronary artery disease: Ventricular aneurysm and coronary artery stenosis

Two patients with diastolic murmurs resulting from common sequelae of atherosclerotic coronary artery disease are presented. In the first patient, aortic insufficiency resulting from a left ventricular aneurysm was documented antemortem by aortography. Postmortem examination revealed normal aortic valve leaflets. The second patient demonstrated a diastolic murmur due to blood flow through a stenosis of the left coronary artery. The murmur receded when a myocardial infarction occurred in the area of the heart supplied by this artery. Although the murmur suggested aortic insufficiency, there were differentiating features and a competent aortic valve was demonstrated by antemortem aortography.