| Condition |
Pulse |
Apex beat |
Heart sounds |
Murmur timingĀ |
Murmur site |
Murmur radiation |
Peripheral features |
| Aortic stenosis |
Slow-rising, small volume |
Pressure loaded |
A2 , 4+ |
Ejection systolic |
Aortic area |
Carotids |
Narrow pulse pressure |
| Mitral regurgitation |
+/- Atrial fibrillation |
Volume loaded |
P2 , 3+ |
Pan-systolic |
Apex |
Axilla |
RVHeave |
| Aortic regurgitation |
Collapsing, large volume |
Volume loaded |
A2 , 3+ |
Early diastolic |
Lower left sternal edge |
Apex if severe |
Wide pulse pressure |
| Mitral stenosis |
Small volume, +/- atrial fibrillation |
Tapping |
S1 , P2 , opening snap |
Mid-late diastolic |
Apex |
Axilla |
Malar flush, RV heave |
| Tricuspid regurgitation |
Normal |
Normal |
Normal |
Pan-systolic |
Tricuspid area |
Nil |
Raised JVP, ascites, Peripheral oedema,pulsatile liver |