Examkin

Question

Difficulty: EasyCardiovascular System

Match each classic auscultatory finding described below with its corresponding valvular heart disease.

  • Harsh, systolic crescendo-decrescendo murmur heard best at the right second intercostal space with radiation to the carotidsAortic valve stenosis
  • Blowing, holosystolic murmur heard best at the cardiac apex with radiation to the left axillaMitral valve regurgitation
  • High-pitched, early diastolic decrescendo murmur heard best at the left third intercostal spaceAortic valve regurgitation
  • Low-pitched, mid-diastolic rumbling murmur with a preceding opening snap heard best at the cardiac apexMitral valve stenosis

Answer

The harsh systolic crescendo-decrescendo murmur matches aortic stenosis; the holosystolic apical murmur matches mitral regurgitation; the early diastolic decrescendo murmur matches aortic regurgitation; and the mid-diastolic rumble with an opening snap matches mitral stenosis.
Each valvular lesion produces characteristic acoustic phenomena based on the anatomical location of the affected valve and the specific phase of the cardiac cycle during which abnormal, turbulent blood flow occurs.

Step-by-Step Solution

1
Analyze the timing of the murmur in the cardiac cycle.
Determine if the murmur occurs during systole (ejection phase) or diastole (ventricular filling).
Timing is the first fundamental step in narrowing the differential diagnosis for valvular lesions.
2
Identify the location of maximal intensity and characteristic radiation patterns.
Map the murmur to specific anatomical locations, such as the apex (mitral area) or the right upper sternal border (aortic area).
Different valve pathologies project acoustic energy in specific, predictable directions based on blood flow anatomy.
3
Synthesize the timing, location, and acoustic qualities to identify the pathology.
Accurately pair the clinical description with the correct valvular diagnosis.
Combining these features provides a definitive bedside diagnosis for classic valvular presentations.

Key Concept

Classic auscultatory findings of major valvular heart diseases
Estimated Time:45s
Rate this question

Topics

Cardiovascular System

More questions from this topic