Acute severe aortic regurgitation is associated with a three phase murmur, specifically a midsystolic murmur followed by S2, followed by a parasternal early diastolic and mid-diastolic murmur (Austin Flint murmur). Although the exact cause of an Austin Flint murmur is unknown, it is hypothesized that the mechanism of murmur is from the severe aortic regurgitation jet vibrating the anterior mitral valve leaflet, colliding with the mitral inflow during diastole, with increased mitral inflow velocity from the narrowed mitral valve orifice leading to the jet impinging on the myocardial wall.