Which maneuver is known to increase the intensity of the aortic regurgitation murmur?

Which maneuver is known to increase the intensity of the aortic regurgitation murmur?

• A. Valsalva maneuver
• B. Standing
• C. Squatting
• D. Sitting and leaning forward

Answer: (D)

The key idea is how body position and breathing affect how the regurgitant jet transmits to the chest. For aortic regurgitation, the diastolic murmur is best heard when the patient sits up and leans forward during expiration. This position brings the heart closer to the chest wall, lets the regurgitant flow into the LV be transmitted more clearly, and amplifies the diastolic sound. That’s why sitting up and leaning forward is the maneuver that most reliably increases its intensity. Other maneuvers that reduce venous return or preload tend to dampen murmurs, while changes in preload and afterload from squatting can alter sounds but don’t consistently boost AR the way the leaning-forward position does.

The key idea is how body position and breathing affect how the regurgitant jet transmits to the chest. For aortic regurgitation, the diastolic murmur is best heard when the patient sits up and leans forward during expiration. This position brings the heart closer to the chest wall, lets the regurgitant flow into the LV be transmitted more clearly, and amplifies the diastolic sound. That’s why sitting up and leaning forward is the maneuver that most reliably increases its intensity. Other maneuvers that reduce venous return or preload tend to dampen murmurs, while changes in preload and afterload from squatting can alter sounds but don’t consistently boost AR the way the leaning-forward position does.