In mitral stenosis, the murmur occurs:
A. From S1 through S2 as a holosystolic murmur
B. After an opening snap that is heard after S2 during diastole
C. As a soft mid-systolic click
D. A loud crescendo-decrescendo systolic murmur
ANS: B
Mitral stenosis results from thickening and stiffening of the mitral valve, usually secondary to rheumatic fever. The murmur is generally grade I to IV and low pitched; therefore, it is heard better with the bell at the apex in the left lateral recumbent position. The first heart sound (S1) is loud, followed by S2 and a loud opening snap that precedes the murmur.
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