Heart murmurs

Question 1

Holosystolic, high pitched blowing murmur. Heard at apex, radiates towards axilla. Enhanced by squatting, hand grip (increase TPR).

Answer 1

Mitral regurgitation

Question 2

Holosystolic, high pitched blowing murmur. Heard at tricuspid area and radiates to right sternal border. Enhanced by inspiration (increased RA return).

Answer 2

Tricuspid regurgitation

Question 3

Crescendo-descrescendo systolic ejection murmur. Loudest at heart base, radiates to carotid.

Answer 3

Aortic stenosis

Question 4

Pulsus parvus et tardus

Answer 4

Aortic stenosis

Question 5

Syncope, angina, and dyspnea on exertion

Answer 5

Aortic stenosis

Question 6

Holosystlic, harsh-sounding murmur. Loudest at tricuspid area, accentuated with hand grip maneuver (increased afterload)

Answer 6

Ventricular Septal Defect

Question 7

Late systolic crescendo murmur with midsystolic click. Heard over apex. Loudest before S2.

Answer 7

Mitral valve prolapse

Question 8

Blowing early diastolic decrescendo murmur. Increased murmur during handgrip.

Answer 8

Aortic regurgitation

Question 9

Wide pulse pressure when chronic, bounding pulses and head bobbing

Answer 9

Aortic regurgitation

Question 10

Murmur follows opening snap in diastole. Delayed rumbling late diastolic murmur. Enhanced with expiration (increased left atrial return).

Answer 10

Mitral stenosis

Question 11

Continuous machine-line murmur. Loudest at S2. Heard best at left infraclavicular area.

Answer 11

Patent Ductus Arteriosus (often due to congenital rubella) or prematurity.