| Valve Anomally |
Location |
Radiation |
Intensity |
Pitch |
Quality |
Aid |
| Mitral Stenosis |
Usually limited to apex |
Little or none |
Grade 1 to 4 |
Low. use bell |
OS follows S2 |
Bell on apex, pt in LL pos. on exhilation |
| Aortic Stenosis |
2nd RT |
neck and L sternal boder, apex |
soft but often loud, w/ thrill |
medium-high@apex |
harsh, musical at apex, diamond shape |
pt sitting/leaning fwd |
| Tricuspid Regurgitation |
LL sternal border |
RT sternum, xiphoid, Lt MCL |
Variable |
Medium |
Blowing, holosystolic |
Inspiration |
| Ventricular Septal Defect |
3,4,5th Left |
often wide |
very loud, w/ thrill |
high |
often harsh, holosystolic |
Lf-Rt hole |
| Mitral regurgitation |
apex |
Left axilla, Lt sternal boder |
soft to loud,apical thrill |
medium-high |
blowing, holosystolic |
Lf Vent-Rt Atrium |
| Aortic regurgitaion |
2-4th left |
if loud to apex, Rt sternal boder |
grade 1-3 |
high, use diaphragm |
blowing, decrescendo diastolic |
pt sitting/leaning fwd w/ breath held in exhilation |
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