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Review of Clinical Signs Review Questions

Auscultation of the Heart

Author: Bernard Karnath, MD

1. A 60-year old man has a 2-month history of progressive dyspnea and chest pain. Cardiac auscultation reveals a grade 3 systolic ejection murmur that is heard best at the second right interspace. The murmur radiates into the carotid arteries. What is the most likely underlying valvular abnormality?
  1. Aortic regurgitation
  2. Aortic stenosis
  3. Mitral regurgitation
  4. Mitral stenosis
Click here to compare your answer.


2. A 40-year-old woman has a 3-month history of progressive dyspnea. Cardiac auscultation reveals a grade 3 diastolic murmur heard best at the apex. The murmur is low-pitched and has a rumbling quality. There is a snapping sound that immediately precedes the murmur. What is the most likely underlying valvular abnormality?

  1. Aortic regurgitation
  2. Aortic stenosis
  3. Mitral regurgitation
  4. Mitral stenosis
Click here to compare your answer.


3. During a routine physical examination of a 30-year-old man, cardiac auscultation reveals a grade 3 systolic ejection murmur heard best at the left lower sternal border. The murmur does not radiate into the carotid arteries and becomes louder when the patient is asked to perform the Valsalva maneuver. What is the most likely underlying cardiac abnormality?

  1. Aortic stenosis
  2. Dilated cardiomyopathy
  3. Hypertrophic cardiomyopathy
  4. Mitral regurgitation
Click here to compare your answer.

4. A 50-year-old woman has a 3-month history of progressive dyspnea. Cardiac auscultation reveals a grade 3 pansystolic murmur heard best at the apex. The murmur is medium-pitched and radiates to the axilla. What is the most likely underlying valvular abnormality?
  1. Aortic regurgitation
  2. Aortic stenosis
  3. Mitral regurgitation
  4. Mitral stenosis
Click here to compare your answer.


5. During a routine physical examination of a 15-year-old boy, cardiac auscultation reveals a grade 3 systolic ejection murmur heard best at the left second interspace. S2 is widely split and fixed (ie, does not vary with respirations). What is the most likely underlying cardiac abnormality?

  1. Atrial septal defect
  2. Ventricular septal defect
  3. Aortic stenosis
  4. Pulmonic stenosis
Click here to compare your answer.




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