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What are the different murmur types and clinical findings in different valve lesions?

 

Condition Pulse Apex beat Heart sounds Murmur timingĀ  Murmur site Murmur radiation Peripheral features
Aortic stenosis Slow-rising, small volume Pressure loaded A2 , 4+ Ejection systolic Aortic area Carotids Narrow pulse pressure
Mitral regurgitation +/- Atrial fibrillation Volume loaded P2 , 3+ Pan-systolic Apex Axilla RVHeave
Aortic regurgitation Collapsing, large volume Volume loaded A2 , 3+ Early diastolic Lower left sternal edge Apex if severe Wide pulse pressure
Mitral stenosis Small volume, +/- atrial fibrillation Tapping S1 , P2 , opening snap Mid-late diastolic Apex Axilla Malar flush, RV heave
Tricuspid regurgitation Normal Normal Normal Pan-systolic Tricuspid area Nil Raised JVP, ascites, Peripheral oedema,pulsatile liver

 

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