Heart Murmur Quiz
Questions: 16 · 10 minutes
1. A loud holosystolic murmur is heard best at the lower left sternal border in a child. Which structural finding is a classic cause?
Aortic coarctation
Atrial septal defect
Ventricular septal defect
Patent ductus arteriosus
2. Which pattern is most compatible with an innocent murmur, while still requiring clinical context for interpretation?
A diastolic murmur accompanied by exertional fainting
A new continuous murmur with blue or gray lips
A soft systolic murmur that varies with position in a person without symptoms
A harsh murmur with a palpable thrill and neck radiation
3. A systolic murmur occurs during which part of the cardiac cycle?
From S2 until the next S1
Before S1 but never after it
Only during the pause after diastole
Between S1 and S2
4. A continuous, machinery-like murmur is heard most clearly near the left upper chest below the clavicle. Which condition is classically associated with this finding?
Ventricular septal defect
Patent ductus arteriosus
Tricuspid regurgitation
Hypertrophic obstructive cardiomyopathy
5. A clinician suspects mitral stenosis and wants to hear its low-frequency diastolic rumble more clearly. Which technique is most appropriate?
Apply the bell lightly at the apex with the patient in the left lateral position
Use the diaphragm at the apex while the patient stands
Use the bell firmly over the carotid artery during inspiration
Press the diaphragm firmly over the right upper sternal border
6. While comparing a murmur during quiet breathing, which change most strongly suggests that it originates on the right side of the heart?
It consistently radiates to both carotid arteries
It becomes louder during sustained handgrip only
It disappears whenever the patient exhales
It becomes louder during inspiration
7. A high-pitched, blowing murmur begins immediately after S2. It is heard best along the left sternal border with the patient leaning forward at end-expiration. Which lesion fits best?
Mitral regurgitation
Mitral valve prolapse
Pulmonic stenosis
Aortic regurgitation
8. How does the classic click and murmur of mitral valve prolapse usually change when reduced ventricular filling makes the left ventricle smaller, as during standing or Valsalva strain?
The click occurs later and the murmur becomes shorter
The click occurs earlier and the murmur becomes longer
The click disappears while the murmur becomes diastolic
The sound shifts to the right upper sternal border
9. What produces the sound described as a heart murmur?
Turbulent blood flow within or near the heart
Electrical impulses traveling through the conduction system
Normal opening of the coronary arteries
Movement of air through tissue beside the heart
10. A patient's systolic murmur becomes louder during the strain phase of the Valsalva maneuver. Which condition is especially known for this response?
Fixed aortic stenosis
Hypertrophic obstructive cardiomyopathy
Mitral stenosis
Aortic regurgitation
11. A clinician asks a patient to squeeze both hands firmly while listening to a suspected mitral regurgitation murmur. What change is typically expected?
The murmur becomes continuous through systole and diastole
The murmur moves from the apex to the neck
The murmur becomes louder as systemic vascular resistance rises
The murmur becomes quieter because venous return stops
12. A holosystolic murmur is loudest at the cardiac apex and radiates toward the left axilla. Which condition is the classic match?
Pulmonic stenosis
Mitral regurgitation
Tricuspid stenosis
Aortic stenosis
13. A harsh crescendo-decrescendo systolic murmur is loudest at the right second intercostal space and radiates toward the neck. Which lesion best matches this pattern?
Aortic stenosis
Aortic regurgitation
Mitral regurgitation
Mitral stenosis
14. Which general statement about a diastolic heart murmur is most accurate?
It can be identified reliably without considering S1 and S2
It is usually an innocent finding in healthy adults
It always indicates obstruction of an outflow valve
It is generally considered pathologic and warrants clinical evaluation
15. Which finding accompanying a newly recognized murmur most clearly calls for urgent medical assessment?
Brief awareness of the heartbeat after drinking coffee
Chest-wall tenderness that appears only when the area is pressed
Fainting during physical exertion
Occasional hiccups after eating quickly
16. Which auscultatory pattern is most characteristic of mitral stenosis?
An opening snap followed by a low-pitched diastolic rumble at the apex
A harsh systolic murmur radiating to the carotids
A continuous murmur beneath the left clavicle
An early diastolic blowing murmur at the left sternal border