Heart Disease
Aortic Stenosis
Aortic Regurgitation
Mitral Stenosis
Normal MV area: 4-6
cm2
Mitral Regurgitation
Pulmonic Stenosis
Hypertrophic
Cardiomyopathy
Tricuspid Regurgitation
VSD
Aortic Stenosis
Pulmonic Stenosis
Hypertrophic CM
Murmur
Mid-systolic at the 2nd3rd interspaces
Diastolic blowing
murmur at the left
sternal border, 3rd-4th
ICS
Austin Flint Murmur
Harsh Systolic
murmur
Diastolic murmur,
usually limited to the
apex
Holo/Pansystolic
murmur at the apex
Midsystolic at the left
2nd and 3rd interspaces
Midsystolic murmur
at the left 3rd and 4th
interspaces
Holo/Pansystolic
murmur at the lower
left sternal border
Holo/Pansystolic
Murmur at the 3rd, 4th
and 5th interspaces
Radiation
Often to the carotids,
down to the left sternal
border, even to the
apex.
Severe: May radiate to
the left 2nd and 3rd
interspaces
If loud, to the apex,
perhaps to the right
sternal border
Increased intensity:
Decreased Intensity
Pulse
Squatting
Release Phase
Expiration
Standing
Strain
Pulsus Parvus
Pulsus tardus
Wide pulse pressure
De Musset Sign
Corrigan Pulse
Traube Sign
Duroziez Sign
Muller Sign
Quincke Sign
Handgrip
Little or none
To the left axilla, less
often to the left sternal
border
If loud, toward the left
shoulder and neck
Down the left sternal
border to the apex,
possibly to the base, but
not the neck
To the right of sternum,
to the xiphoid area, and
at times at the left MCL,
but not into the axilla
Often wide, depending
on the size of the defect.
Systolic Murmur
VSD
Tricuspid Regurgitation
Mitral Regurgitation
Others
Handgrip
Handgrip
Expiration
Handgrip
Inspiration
Standing
Strain Phase
Squatting
Release Phase
Handgrip
Inspiration
Smaller defects have
murmurs of higher
pitch.
Handgrip
Diastolic Murmur
Aortic Regurgitation
Mitral Stenosis