Describe MS Murmur in Diastolic Murmurs briefly?

Characteristic: Low pitched, rumbling and diastolic murmur, loudest at apex with patient in left lateral decubitus, with pre systolic crescendo due to atrial contraction at the end of diastole.

Increasing flow across the mitral valve as by handgrip exercise, squatting, arnyl nitrite inhalation makes the inurinur louder, Low flow across the mitral valve makes the murmur softer.

Mitral diastolic inflow murmur is a low pitched rumble heard over apex and generated due to excessive flow via a normal mitral valve as in severe MR, large left to right shunts (PDA, VSD). It doesn't have presystolic accentuation and isn't preceded with an OS. Carey Coombs murmur is a diastolic inflow murmur heard in patients with MR with acute Rheumatic fever.

Figure: Murmur of mitral stenosis in various clinical situations