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It extends from a point in the second left intercostal space, about 2.5 mm. from the sternal margin, obliquely downward, with a convexity to the left, to the apex of the heart. This is contrasted with the acute margin of the heart, which is at the border of the anterior and posterior surface, and in which the acute marginal branch of the right ...
It is best heard at the left upper sternal border. This is the result of an increased volume going through the pulmonary valve. It has association with a fixed, split S2 and a right ventricular heave. Ventricular septal defect (VSD) will present as a holosystolic murmur. One can hear it at the left lower sternal border.
Any maneuver that increases left ventricular volume — such as squatting, elevation of legs, hand grip, and phenylephrine — can delay the onset of clicks, shorten murmur duration, and increase murmur intensity. Late systolic Tricuspid valve prolapse Uncommon without concomitant mitral valve prolapse. Best heard over left lower sternal border.
The murmur is low intensity, high-pitched, best heard over the left sternal border or over the right second intercostal space, especially if the patient leans forward and holds breath in full expiration. The radiation is typically toward the apex. The configuration is usually decrescendo and has a blowing character.
A left-sided S3 is best heard in the left lateral decubitus position and at the apex of the heart, which is normally located in the 5th left intercostal space at the midclavicular line. A right-sided S3 is best heard at the lower left sternal border.
Still's murmur is detected via auscultation with a stethoscope.It has a peculiar "musical", "resonant" or "vibratory" quality that is quite unique. [1] [2] It is generally most easily heard at the left middle or lower sternal border and the right upper sternal border, often with radiation to the carotid arteries, although other locations are common.
The sternal angle is located at the point where the body joins the manubrium. The sternal angle can be felt at the point where the sternum projects farthest forward. However, in some people the sternal angle is concave or rounded. During physical examinations, the sternal angle is a useful landmark because the second rib attaches here. [1]
In cardiology, Erb's point refers to the third intercostal space on the left sternal border where S2 heart sound is best auscultated. [5] [6] Some sources include the fourth left interspace. [7] Human female breasts are located on the chest wall, most frequently between the second and sixth rib. [4]