Heart murmur and abnormal heart sound recognition tested on USMLE Step 1.
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- What is the timing and quality of the aortic stenosis murmur?
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A crescendo-decrescendo (harsh) systolic ejection murmur
- Where does the aortic stenosis murmur classically radiate?
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To the carotid arteries
- What carotid pulse finding is classic for severe aortic stenosis?
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Pulsus parvus et tardus (weak and delayed upstroke)
- What is the timing and location of the mitral regurgitation murmur?
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A holosystolic murmur best heard at the cardiac apex
- Where does the mitral regurgitation murmur typically radiate?
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To the axilla
- What two auscultatory findings characterize mitral stenosis?
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A mid-diastolic rumble preceded by an opening snap
- In mitral stenosis, what does a shorter S2-to-opening-snap interval indicate?
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More severe mitral stenosis
- What is the timing and location of the aortic regurgitation murmur?
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An early diastolic, decrescendo murmur at the left sternal border
- What pulse finding is associated with chronic, severe aortic regurgitation?
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A wide pulse pressure with a bounding, water-hammer pulse
- What is the timing and location of the tricuspid regurgitation murmur?
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A holosystolic murmur at the lower left sternal border
- What is Carvallo's sign?
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The tricuspid regurgitation murmur getting louder with inspiration
- What is the character and location of the pulmonic stenosis murmur?
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A systolic ejection murmur at the left upper sternal border
- What is the classic murmur of a ventricular septal defect?
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A holosystolic, harsh murmur at the left lower sternal border
- What is the classic murmur of a patent ductus arteriosus?
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A continuous, machine-like murmur
- How does the hypertrophic obstructive cardiomyopathy murmur change with Valsalva or standing?
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It becomes louder