Which murmur is pansystolic, blowing, high-pitched, and radiates to the left axilla?

Which murmur is pansystolic, blowing, high-pitched, and radiates to the left axilla?

• A. Tricuspid regurgitation
• B. Aortic regurgitation
• C. Mitral stenosis
• D. Mitral regurgitation

Answer: (D)

The key idea is recognizing how the timing, quality, and radiation of a murmur point to the defective valve. A mitral valve leak during systole produces a holosystolic (pansystolic) murmur that has a blowing, high-pitched character. It is heard best at the apex (left 5th intercostal space, midclavicular line) and classically radiates toward the left axilla because the regurgitant jet into the left atrium sends sound along the chest wall and into that region. This helps distinguish it from other murmurs: aortic regurgitation is a diastolic, decrescendo murmur heard along the left sternal border; mitral stenosis is a diastolic rumble with an opening snap; tricuspid regurgitation is holosystolic as well but is best heard along the left lower sternal border and doesn’t typically radiate to the axilla. So the described murmur fits mitral regurgitation because of its holosystolic timing, blowing quality, and axillary radiation.

The key idea is recognizing how the timing, quality, and radiation of a murmur point to the defective valve. A mitral valve leak during systole produces a holosystolic (pansystolic) murmur that has a blowing, high-pitched character. It is heard best at the apex (left 5th intercostal space, midclavicular line) and classically radiates toward the left axilla because the regurgitant jet into the left atrium sends sound along the chest wall and into that region.

This helps distinguish it from other murmurs: aortic regurgitation is a diastolic, decrescendo murmur heard along the left sternal border; mitral stenosis is a diastolic rumble with an opening snap; tricuspid regurgitation is holosystolic as well but is best heard along the left lower sternal border and doesn’t typically radiate to the axilla. So the described murmur fits mitral regurgitation because of its holosystolic timing, blowing quality, and axillary radiation.