Short case: Heart murmurs

Throughout my attachment in SIMC, I have learned how to present a short case on heart murmurs. When patient comes to you, first, identify the age. If patient is old, it is more likely to be aortic stenosis. If patient is young, it can be mitral regurgitation, aortic regurgitation, mitral stenosis or congenital defects such as ventricular septal defect, atrial septal defect and patent ductus arteriosus. Second, check for clubbing and scars. If none is present, congenital defects are unlikely to occur. Next, palpate or auscultate for the apex beat. If it is displaced, it is either mitral regurgitation or aortic regurgitation and hence, mitral stenosis can be ruled out. Now, one is left with either mitral regurgitation or aortic regurgitation. Auscultate the back for murmur. If a systolic murmur is heard from the back, it is mitral regurgitation since that is the only murmur which can be heard from the back.