MRCP UK EXAMINATIONS

Detailed explanation-1: -Usually, it is found in patients with rheumatic heart disease. In this case, the patients will also have either mitral valve disease, aortic valve disease or both, making it hard to appreciate the murmur of tricuspid stenosis.

Detailed explanation-2: -The diastolic murmur of mitral stenosis is of low pitch, rumbling in character, and best heard at the apex with the patient in the left lateral position. It commences after the opening snap of the mitral valve, and the duration of the murmur correlates with the severity of the stenosis.

Detailed explanation-3: -The four most commonly encountered diastolic murmurs include aortic and pulmonary valve regurgitation, and mitral and tricuspid valve rumbles (Table 27.1).

Detailed explanation-4: -The classic mid-diastolic low-pitched rumbling murmur of mitral stenosis with pre-systolic accentuation is best audible at the apex, in the left lateral position with the bell of the stethoscope.