Pulmonic regurgitation: The Daily PANCE Blueprint
A patient has a high-pitched, blowing diastolic murmur best heard at the left 2nd intercostal space that becomes louder with inspiration. What condition does this most likely represent?
A. Aortic regurgitation
B. Mitral stenosis
C. Pulmonic regurgitation
D. Tricuspid stenosis
E. None of the above
Answer and topic summary
The answer is C. Pulmonic regurgitation
Pulmonic regurgitation is a diastolic murmur, located at the LEFT 2nd ICS. It increases with inspiration. It is often described as high-pitched and blowing. Causes include iatrogenic (MCC), infectious, immune-mediated, systemic (carcinoid), due to PAH, or congenital. Management depends on severity (i.e., monitoring for asymptomatic patients, valve replacement for symptomatic patients OR for asymptomatic patients with severe RV failure and reduced RV systolic function).
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