Mitral regurgitation

Auscultation

 * Location: best audible with the diaphragm at the apex
 * Description: blowing, high-pitched holosystolic regurgitant murmur
 * Radiation: typically into the left axilla
 * Maneuvers: augmented during expiration or isometric handgrip
 * Variations :
 * MR due to posterior leaflet prolapse may be anteriorly directed toward the left sternal border
 * MR may not be holosystolic in the following settings
 * Murmurs of MR may be early systolic with acute severe MR due to rapid equalization of LA and LV pressures
 * Murmurs of MR may be mid-to-late systolic following a click in MVP
 * Murmurs of MR may be late systolic in ischemic MR due to papillary muscle dysfunction


 * Associated findings
 * Laterally displaced PMI
 * Soft S1 ± S3
 * P2 component may be augmented when pulmonary hypertension occurs