Bedside maneuvers for murmurs

Question 1

Inspiration

Answer 1

↑ intensity of RH sounds

Question 2

Hand grip (↑ systemic vascular resistance)

Answer 2

↑ MR, AR, VSD
↓ AS, Hypertrophic cardiomyopathy
MVP - ↑ intensity, later onset click

Question 3

Valsalva/Standing (↓ VR)

Answer 3

↓ Most murmurs
↑ Hypertrophic cardiomyopathy
MVP - ↓ intensity, earlier onset click

Question 4

Rapid squatting (↑ VR, preload, afterload)

Answer 4

↓ Hypertrophic cardiomyopathy
↑ AS
MVP - ↑ intensity, later onset click