Mid diastolic murmurs:
- mitral stenosis - maximal at the apex with the patient inclined to the left. The murmur begins after the opening snap. The murmur is long if severe and short if mild.
- tricuspid stenosis - maximal at the lower left sternal edge. The murmur is increased by inspiration.
- a murmur mimicking mitral stenosis may occur when there is greatly increased flow across the mitral valve. This may occur in mitral regurgitation, VSD, patent ductus, causes of a hyperdynamic circulation e.g. thyrotoxicosis.
Last reviewed 01/2018