In mitral stenosis, the murmur can be best heard with the patient in the:
A. Squatting position
B. Seated position
C. Left lateral recumbent
D. Supine position
ANS: C
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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