FindingSignificance
Systolic murmurTurbulent flow of blood through a dynamic outflow tract obstruction. The murmur increases with activities that decrease the end diastolic volume of the left ventricle.
Second right intercostal space and/or left sternal border
Murmur increases with standing and decreases with squatting
May radiate to neck
Lateral displacement of apical impulseHypertrophy and failure of left ventricle
Holosystolic murmur of mitral regurgitation at apex with radiation to axillaMalposition of mitral valve during systole, which interferes with valve closure