Valvular Heart Disease

Question 1

A patient presents with a diastolic murmur at the upper left sternal edge. What might it be? What could make it louder?

Answer 1

• Pulmonary regurgitation
• Inspiration

Question 2

A patient presents with a pansystolic murmur at the apex that radiates to the axilla. What is it most likely to be? What could make it louder?

Answer 2

• Mitral regurgitation
• Expiration, squatting

Question 3

A patient presents with a diastolic murmur at the upper right sternal edge. What is it most likely to be? What could make it louder?

Answer 3

• Aortic regurgitation
• Expiration, leaning forward

Question 4

A patient presents with a diastolic murmur at the left lower sternal edge. What is it most likely to be?

Answer 4

• Tricuspid stenosis
• Inspiration

Question 5

A patient presents with a low-pitched diastolic murmur at the apex that radiates to the axilla. What is it likely to be? What could make it louder?

Answer 5

• Mitral stenosis
• Expiration, left lateral position

Question 6

A patient presents with a systolic murmur at the upper left sternal edge. What is it most likely to be? What could make it louder?

Answer 6

• Pulmonary stenosis
• Inspiration

Question 7

A patient presents with a crescendo/decrescendo systolic murmur that radiates to the carotids. What is it likely to be? What could make it louder?

Answer 7

• Aortic stenosis
• Expiration, squatting

Question 8

A patient presents with a systolic murmur at the lower left sternal edge. What is it most likely to be? What could make it louder?

Answer 8

• Tricuspid regurgitation
• Inspiration