It is related to direction of the blood jet which leads to selective conduction of the murmur to right sided neck (carotid) in AS and to left axilla and back in MR (especially rheumatic MR). MVP MR on the other hand, due to prolapse of posterior mitral leaflet, has a blood jet direction medially (instead of laterally) towards the left sternal border near the aortic area.
MR murmur can radiate to axilla or towards cardiac base depending on which leaflet is affected. But the question is why MR murmur is best heard at apex? Apex is not where mitral valve is located. Kindly answer.
Thank you Dr. Sonali for your wonderful lecture. I have a question about why some patients have the phenomenon of Gallavardin or others not. Are there any mechanism other than peak velocity across aortic valve? I think patient's BMI has some relation.
