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DYNAMIC CARDIAC AUSCULTATION MANOEUVRES

Cardiology

DYNAMIC CARDIAC AUSCULTATION MANOEUVRES

1. Inspiration - DIASTOLIC murmurs of the right side of the heart (TV, PV) become louder.
2. Expiration - SYSTOLIC murmurs of the left side of the heart (MV, AV) become louder.
3. Leaning forwards + full expiration - AR becomes prominent.
4. Standing & valsalva strain phase - hypertrophic cardiomyopathy + MVP become prominent.
5. Squatting - AS + MR become louder.

TIP
6. Right-sided murmurs and heart sounds are louder during inspiration and any maneuvers that increase venous return, such as passive leg raising and abdominal compression.
7. Left-sided murmurs and heart sounds are louder during expiration.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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