A patient has a blowing, high-pitched sound heard at the fifth intercostal space, left midclavicular line, that radiates to his left axilla. This sound is most likely the result of
a. mitral stenosis. c. pericardial friction rub.
b. mitral regurgitation. d. ventricular gallop.
B
When a patient has mitral regurgitation, it produces a murmur with a blowing, high-pitched sound heard at the apex, fifth ICS, left midclavicular line. It radiates to the left axilla and back.
Mitral stenosis causes a murmur with a rumbling, low-pitched sound heard best at the apex, fifth ICS, left midclavicular line. It may get louder with the patient on the left side. It does not radiate. A pericardial friction rub produces a murmur that is high-pitched and sounds leathery, scratchy, or grating. It is located at the third to fifth ICS, left of the sternum, and does not radiate. A ventricular diastolic gallop is also known as the third heart sound.
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