Mitral regurgitation physical examination

Phonocardiograms from normal and abnormal heart sounds

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Findings on clinical examination depend on the severity and duration of mitral regurgitation. The mitral component of the first heart sound is usually soft and with a laterally displaced apex beat, often with heave. The first heart sound is followed by a high-pitched holosystolic murmur at the apex, radiating to the back or clavicular area. Its duration is, as the name suggests, the whole of systole. The loudness of the murmur does not correlate well with the severity of regurgitation. It may be followed by a loud, palpable P₂, heard best when lying on the left side. A third heart sound is commonly heard.