PRESENT-DAY popularity of surgery for cardiac valve disease of acquired origin has made precise diagnosis of valve lesions of the utmost importance. Success of surgery may depend, among other factors, upon the nature of the pathologic changes within the valve itself and upon the total number of valves involved. Our anatomic studies have shown how often associated valve lesions are overlooked in the presence of mitral valve disease.1 These findings likewise have emphasized the importance and the frequency of multivalvular lesions in persons with rheumatic heart disease who die and particularly those who die of congestive heart failure. By implication, these findings have further emphasized the well-known fact that murmurs which are so frequently characteristic of specific valve lesions may also be uncharacteristic for them. A single murmur may represent an auditory fusion of murmurs originating from several valve abnormalities. Moreover, with changing cardiac function, murmurs may change their