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