A series of adult patients present for routine cardiovascular evaluation. For each described auscultatory profile and maneuver response, select the most appropriate underlying structural heart disease.
- Late systolic murmur preceded by a mid-systolic click; the murmur becomes longer and moves closer to S1 with the Valsalva maneuver.Mitral valve prolapse
- Harsh crescendo-decrescendo systolic murmur at the right upper sternal border with radiation to the carotids; decreases in intensity with handgrip.Aortic stenosis
- High-pitched, early diastolic decrescendo murmur best heard at the left sternal border; increases in intensity when the patient leans forward.Aortic regurgitation
- Holosystolic murmur at the left lower sternal border; increases in intensity with deep inspiration (Carvallo's sign).Tricuspid regurgitation
Answer
The clinical profiles match Mitral valve prolapse, Aortic stenosis, Aortic regurgitation, and Tricuspid regurgitation, respectively.
Each murmur's timing, specific location, and dynamic response perfectly aligns with the mechanical consequences of its corresponding structural heart disease.
Step-by-Step Solution
Key Concept
Clinical recognition and dynamic auscultation of valvular heart diseases.
Estimated Time:1m 30s