Acquired

Question 1

Harsh midsystolic/systolic ejection murmur at right upper sternal border with radiation to the right supraclavicular area
Systolic thrill (suprasternal notch)

Answer 1

Aortic Stenosis

Question 2

Loud S1 at apex
Narrowly split S2 with loud P2
Opening snap (low frequency mitral diastolic rumble at apex)

Answer 2

Mitral Stenosis

Question 3

Blowing, harsh, holosystolic murmur best heard at apex

Systolic regurgitant murmur Gr. 2-4/6 at apex with transmission to left axilla
S1: normal or diminished
S2: widely split
S3: loud
Short, low frequency diastolic rumble at apex

Answer 3

Mitral Regurgitation

Question 4

Widened pulse pressure

Blowing, decrescendo diastolic murmur heard best at the RUSB/2nd ICS right

Answer 4

Aortic Regurgitation

Question 5

Systolic click
Standing: decreased EDV = closer to S1
Squatting: increased EDV = closer to S2

Answer 5

Mitral Valve Prolapse

Question 6

Gr. 3/6 systolic regurgitant murmur radiating to left anterior axillary line

Answer 6

Infective endocarditis

Question 7

Systolic ejection murmur at left upper sternal border with radiation to upper back
(+) ejection click, (+) systolic thrill
RV heave, widely split S2

Answer 7

Pulmonic Stenosis

Question 8

Early diastolic decrescendo murmur heard best at the LUSB

Answer 8

Pulmonic regurgitation

Question 9

Diastolic and soft rumble heard best at the LLSB, Carvallo Sign

Answer 9

Tricuspid stenosis

Question 10

Harsh, holosystolic murmur heard best at the LLSB, Carvallo sign

Answer 10

Tricuspid regurgiation