Valvular Heart Disease for UPSC CMS: Murmurs, Severity Grading and Surgical Indications

Mitral Stenosis#

Opening snap after A2. Diastolic rumble, apex, left lateral decubitus, presystolic accentuation. Causes: rheumatic (90%). Complications: AF, LA thrombus, pulmonary hypertension, right heart failure.

Mitral Regurgitation#

Pan-systolic murmur, apex, radiates to axilla. Causes: MVP, papillary muscle rupture (post-MI), rheumatic, flail leaflet.

Aortic Stenosis#

Ejection systolic murmur, right 2nd ICS, radiates to carotids. Crescendo-decrescendo. Soft S2. Causes: calcific (elderly), rheumatic, bicuspid valve. Symptoms: angina, syncope, dyspnea.

Aortic Regurgitation#

Early diastolic, high-pitched, decrescendo. Left sternal edge. Causes: aortic root dilation (Marfan), infective endocarditis, rheumatic.