Diastolic heart sound produced by mid-diastolic closure of the mitral valve

Mid-diastolic closure of the mitral valve is suggested as the source for an audible diastolic sound in a patient with aortic valve and coronary artery disease. On the apex cardiogram the sound followed the rapid filling wave by 60 msec and preceded the a wave. On the echocardiogram the sound corresponded to premature closure of the mitral valve in mid-diastole. In this case an audible diastolic sound that appeared to originate from mid-diastolic closure of the mitral valve indicated a rapidly increasing left ventricular diastolic pressure with severe left ventricular failure. After treatment of the congestive heart failure, the sound diminished in intensity.