Rosh Internal Medicine Boost Practice Exam

What is the typical presentation of mitral regurgitation?

1. Diastolic murmur at the left sternal border

2. High-pitched systolic murmur best heard at the apex

3. Low-frequency rumbling diastolic murmur

4. Crescendo-decrescendo systolic murmur

The correct answer is: High-pitched systolic murmur best heard at the apex

The typical presentation of mitral regurgitation involves a high-pitched systolic murmur best heard at the apex of the heart and often radiating to the left axilla. This is due to the backflow of blood from the left ventricle into the left atrium during systole, resulting in turbulent blood flow that produces the characteristic murmur. The high-pitched quality of this murmur is significant as it helps to differentiate it from other heart sounds. The timing during systole is also crucial, as it distinguishes mitral regurgitation from conditions that produce diastolic murmurs, which would occur during the heart's relaxation phase. The anatomical location of the murmur is also telling; it is typically loudest at the apex due to the proximity of the mitral valve. Other choices reflect different types of heart valve sounds or conditions: diastolic murmurs are typical of mitral stenosis, low-frequency sounds usually indicate other valvular problems, and the crescendo-decrescendo pattern is indicative of aortic stenosis rather than mitral regurgitation. Understanding these distinctions is crucial for accurate diagnosis and management of cardiovascular conditions.