During cardiac examination you notice a new parasternal systolic murmur of 2/6 intensity. On palpation, the PMI is slightly higher than usual. What do you suspect?
A) Mammary souffle
B) Mitral stenosis
C) Mitral regurgitation
D) Aortic insufficiency
A) Mammary soufflé
Although a mammary souffle may be diastolic, the murmurs of mitral stenosis and aortic insufficiency cannot be heard in systole. Mitral regurgitation is a possibility, but the upward shift in PMI and lack of other symptoms make this less likely. Any new diastolic murmur should be investigated further.
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