Valvular heart disease: high-yield murmurs

Key points

1. Aortic stenosis: crescendo–decrescendo systolic murmur at the right upper sternal border radiating to the carotids.
2. Mitral regurgitation: holosystolic murmur at the apex radiating to the axilla.
3. Aortic regurgitation: early diastolic decrescendo murmur at the left sternal border.
4. Mitral stenosis: opening snap followed by a low-pitched diastolic rumble at the apex.
5. Squatting increases most murmurs but softens the murmur of hypertrophic cardiomyopathy and the click of mitral valve prolapse moves later.