A blowing holosystolic murmur at the apex with a split S2 is most consistent with which diagnosis?

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Multiple Choice

A blowing holosystolic murmur at the apex with a split S2 is most consistent with which diagnosis?

A holosystolic, blowing murmur best heard at the apex that often radiates to the axilla points to mitral regurgitation. During systole, blood flows backward from the left ventricle into the left atrium, producing that continuous, loud murmur throughout the entire systole. The split S2 can be seen if there’s accompanying pulmonary hypertension from chronic MR, which makes the P2 component louder or delayed, widening the split. By contrast, aortic stenosis causes a harsh systolic murmur at the right upper sternal border with a different S2 pattern; mitral valve prolapse presents with a midsystolic click followed by a murmur that peaks later in systole; and tricuspid stenosis causes a diastolic rumble at the left lower sternal border, not a holosystolic apex murmur.

A holosystolic, blowing murmur best heard at the apex that often radiates to the axilla points to mitral regurgitation. During systole, blood flows backward from the left ventricle into the left atrium, producing that continuous, loud murmur throughout the entire systole. The split S2 can be seen if there’s accompanying pulmonary hypertension from chronic MR, which makes the P2 component louder or delayed, widening the split.

By contrast, aortic stenosis causes a harsh systolic murmur at the right upper sternal border with a different S2 pattern; mitral valve prolapse presents with a midsystolic click followed by a murmur that peaks later in systole; and tricuspid stenosis causes a diastolic rumble at the left lower sternal border, not a holosystolic apex murmur.

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