manuevers effect on murmurs table

PR PS TR TS AR AS MR MS VSD HOCM MVP Inspirati on Increas e Increas e Increas e Increas e Decreas e or no change Decreas e or no change Decreas e or no change Decreas e or no change Usu. no change. But may decreas e. Increase or no change Increas e or no change. May have earlier onset. Hand Grip -- -- -- -- Increas e Decreas e (usu. minimal ) or no change Increas e Increas e (usu. minimal ) or no change Increas e Decrease Increas e or no change. Delayed onset. Valsalva Decreas e Decreas e Decreas e Decreas e Decreas e Decreas e Decreas e Decreas e Decreas e Increase Increas e. Earlier onset. Standing Decreas e Decreas e Decreas e Decreas e Decreas e Decreas e Decreas e Decreas e Decreas e Increase Increas e. Earlier onset. Squatting Increas e Increas e Increas e Increas e Increas e Increas e or no change Increas e Increas e Increas e Decrease Decreas e or no change. Delayed onset. Elevate legs Increas e Increas e Increas e Increas e Increas e Increas e Increas e Increas e Increas e or no change Decrease Decreas e

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This summarizes the effects on different maneuvers on cardiac murmurs. For USMLE.

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PRPSTRTSARASMRMSVSDHOCMMVP

InspirationIncreaseIncreaseIncreaseIncreaseDecrease or no changeDecrease or no changeDecrease or no changeDecrease or no changeUsu. no change. But may decrease. Increase or no changeIncrease or no change. May have earlier onset.

Hand Grip--------IncreaseDecrease (usu. minimal) or no changeIncreaseIncrease (usu. minimal) or no changeIncreaseDecreaseIncrease or no change. Delayed onset.

ValsalvaDecreaseDecreaseDecreaseDecreaseDecreaseDecreaseDecreaseDecreaseDecreaseIncreaseIncrease. Earlier onset.

StandingDecreaseDecreaseDecreaseDecrease

DecreaseDecreaseDecreaseDecreaseDecreaseIncreaseIncrease. Earlier onset.

SquattingIncreaseIncreaseIncreaseIncreaseIncreaseIncrease or no changeIncreaseIncreaseIncreaseDecreaseDecrease or no change.Delayed onset.

Elevate legsIncreaseIncreaseIncreaseIncreaseIncreaseIncreaseIncreaseIncreaseIncrease or no changeDecreaseDecrease

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