Mitral Regurgitation

The MR Murmur is classically holosystolic (from S1 all the way to S2), plateau-shaped. Louder with increased afterload (hand grip or BP cuffs). Loudest at the apex, radiates to the axilla (except in isolated posterior leaflet MR, where it radiates anteriorly to the tricuspid area).

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Patient 12

This is a middle-aged woman who was admitted with complications related to complications of end-stage renal disease; she was found to have 3/6 holosystolic murmur over the apex with radiation to axilla. Echocardiogram demonstrated moderate mitral regurgitation.