You most know the locations of the murmurs
Upper Right Sternal Border = Aortic.
Upper Left Sternal Border = Pulmonic.
Lower Left Sternal Border = Tricupid.
Left 5th intercostal space at midclavicular line = Mitral. So if they say the point the murmur is
t is at the
, you KNOW its a mitral murmur!!
Determine if its a systolic or diastolic murmur
MRS MSD hARD ASS
MR mitral regurgitation Systolic MS mitral stenosis Diastolic AR aortic regurgitation Diastolic AS aortic stenosis Systole If the murmur is at the
upper right sternal border
, it MUST be an
. Is it systolic? Stenosis Diastolic? Regurg.
Right Side murmurs increased with Inspiration
Right-sided heart sounds
increase on inspiration because during inspiration the blood is increased to the heart (less intrathoracic pressure), thus there is more blood flow through the right side of the heart--> louder heart sounds
Left Side murmurs increased with Expiration
sounds increase on expiration because during expiration, you are pushing your blood out into the systemic circulation (more intrathoracic pressure), thus there is more blood flow through the left side of the heart--> louder heart sounds There are a couple places they can trick you.
You need to be able to pick up a click if there is one. Is there a click? Prolapse.
If there's a click and its a diastolic murmur, it CAN'T be prolapse, it has to be Stenosis They're also big on classic associations. If its a
, its almost always in a Marfan's or adult polycystic kidney disease patient.