An asymptomatic 19-year-old female student presents for routine follow-up. On auscultation there is a murmur which on echocardiogram appears to be due to congenital mitral regurgitation. What might the physical findings include?Select the most typical clinical and auscultation findings for the above patient.
In chronic, compensated mitral regurgitation, there is a holosystolic murmur, which starts with SI and extends to or past the aortic component of S2. The SI is diminished, and there is increased splitting of S2. The murmur also radiates from the apex to the axilla. This condition is often tolerated for years before symptoms develop.
soft S1 and holosystolic murmur radiating from the apex to the axilla
early and midsystolic murmur, pulmonary edema, and elevated JVP
diminished S1 only
clear lungs and elevated JVP
C.V.S.