left lateral position: accentuates murmurs of mitral valve disease
when sitting up: accentuates aortic murmurs, ejection clicks, pericardial rub
lying down: functional murmurs are accentuated when the patient is lying down
Valsalva manouevre: the murmur of mitral regurgitation or aortic stenosis becomes softer during the Valsava manouevre. This manouevre causes murmurs of mitral valve prolapse and hypertrophic obstructive cardiomyopathy to become louder. If a patient squats promptly then this has the reverse effects to those occurring in the Valsalva manouevre.
If the patient has a venous hum then this is only heard when the patient is upright. The murmur is accentuated when the patient turns his head away from the side being examined.
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