A high-pitched or musical (whooping) murmur is appreciated over the left apex region in this heart sound, which is plateau (band-shaped) and occurs throughout systole, making it difficult to identify S1 or S2 sounds. This type of high-pitched murmur auscultated over the left apex is typically associated with milder mitral insufficiency and is thought to be high pitched because of vibrations created by loose chordae tendineae early in the disease process.