Which description BEST matches the physical examination finding in a patient with aortic regurgitation?

Which description BEST matches the physical examination finding in a patient with aortic regurgitation?

• A. Holodiastolic blowing murmur with wide pulse pressure
• B. Systolic ejection murmur at the right upper sternal border
• C. Holosystolic murmur at the left lower sternal border
• D. Continuous murmur best heard at the left infraclavicular area

Answer: (A)

Holodiastolic blowing murmur with wide pulse pressure is typical of aortic regurgitation. When the aortic valve fails to close properly, blood leaks backward from the aorta into the left ventricle during diastole. This diastolic runoff lowers aortic diastolic pressure while the stroke volume often increases to maintain forward flow, creating a wide gap between systolic and diastolic pressures—hence a wide pulse pressure and bounding pulses. The murmur itself is an early diastolic, high‑pitched blowing decrescendo sound best heard along the left sternal border, often more noticeable when the patient leans forward and exhales. In contrast, a systolic ejection murmur at the right upper sternal border points to aortic stenosis, a holosystolic murmur at the left lower sternal border suggests mitral regurgitation (or a VSD), and a continuous murmur heard at the left infraclavicular area indicates a patent ductus arteriosus.

Holodiastolic blowing murmur with wide pulse pressure is typical of aortic regurgitation. When the aortic valve fails to close properly, blood leaks backward from the aorta into the left ventricle during diastole. This diastolic runoff lowers aortic diastolic pressure while the stroke volume often increases to maintain forward flow, creating a wide gap between systolic and diastolic pressures—hence a wide pulse pressure and bounding pulses. The murmur itself is an early diastolic, high‑pitched blowing decrescendo sound best heard along the left sternal border, often more noticeable when the patient leans forward and exhales.

In contrast, a systolic ejection murmur at the right upper sternal border points to aortic stenosis, a holosystolic murmur at the left lower sternal border suggests mitral regurgitation (or a VSD), and a continuous murmur heard at the left infraclavicular area indicates a patent ductus arteriosus.