During the cardiac assessment of a client, the nurse hears a loud rumbling during diastole that increases toward the end of the sound. This sound is heard with the bell of the stethoscope over the lower left sternal border. The nurse would suspect which of the following in this client?

Question

1. Aortic stenosis
2. Tricuspid stenosis
3. Mitral regurgitation
4. Pulmonic stenosis

Answer 1

2
Rationale 1: The type of murmur heard with aortic stenosis occurs midsystole and is crescendo-decrescendo.
Rationale 2: The sound heard in this scenario is most likely a murmur related to tricuspid stenosis. Tricuspid stenosis may produce a loud rumbling sound during diastole. The sound increases towards the end of the sound.
Rationale 3: With mitral regurgitation, the sound is heard in systole and is continuous.
Rationale 4: With pulmonary stenosis, the midsystolic sound is heard over the right sternal border in the second intercostal space.