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Since the L ventricle has a higher pressure than the R ventricle, flow during systole occurs from the L to R ventricle, producing the holosystolic murmur. It can be best heard over the left third and fourth intercostal spaces and along the sternal border. It is associated with normal pulmonary artery pressure and thus S2 is normal.
One can hear it at the left lower sternal border. One may see signs of right heart failure on exam. Pulmonary valve regurgitation presents as a diastolic decrescendo murmur. One may hear it at the left lower sternal border. A palpable S2 in the second left intercostal space correlates with pulmonary hypertension due to mitral stenosis.
The intercostal space (ICS) is the anatomic space between two ribs (Lat. costa). Since there are 12 ribs on each side, there are 11 intercostal spaces, each numbered for the rib superior to it. Since there are 12 ribs on each side, there are 11 intercostal spaces, each numbered for the rib superior to it.
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.
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.
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]
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 ...
In the fourth intercostal space (between ribs 4 and 5) just to the right of the sternum (breastbone) V 2: In the fourth intercostal space (between ribs 4 and 5) just to the left of the sternum. V 3: Between leads V 2 and V 4. V 4: In the fifth intercostal space (between ribs 5 and 6) in the mid-clavicular line. V 5: Horizontally even with V 4 ...