Diastolic murmurs that may coexist with the MS murmur are Early diastolic murmur of coexisting aortic regurgitation (AR), which may be conducted to the apex Diastolic flow murmur in the presence of severe MR Mid-diastolic murmur of obstructing left atrial myxoma or ball thrombus (rare) Graham Steell murmur (a soft decrescendo diastolic murmur heard best along the left sternal border and caused by pulmonic regurgitation secondary to severe pulmonary hypertension) Table Diagnosis of Mitral Stenosis Echocardiography Diagnosis of mitral stenosis is suspected clinically and confirmed by echocardiography.