Pulmonic stenosis murmurs are typically heard where?

Pulmonic stenosis murmurs are typically heard where?

• A. Heard in the 2nd and 3rd intercostal spaces with normal JVP and a prominent alpha wave
• B. Heard at the apex during diastole
• C. Caused by left-sided valve insufficiency
• D. Best heard with the patient in the prone position

Answer: (A)

Pulmonic stenosis creates a systolic ejection murmur best heard at the left upper sternal border, typically in the 2nd intercostal space and sometimes extending to the 3rd. It often sounds harsh and may be louder with inspiration because right-sided blood flow increases when you take a breath. In isolated pulmonic stenosis, the jugular venous pressure is usually normal, since the obstruction is at the pulmonary outflow and does not by itself raise right atrial pressures. So hearing the murmur in the left upper sternal border around the 2nd to 3rd interspaces with a normal JVP fits pulmonic stenosis. The other options place the murmur in locations or contexts that don’t match this lesion—for example, a murmur at the apex in diastole suggests a different valve problem, left-sided valve disease isn’t the source here, and a prone position isn’t typical for this outflow obstruction.

Pulmonic stenosis creates a systolic ejection murmur best heard at the left upper sternal border, typically in the 2nd intercostal space and sometimes extending to the 3rd. It often sounds harsh and may be louder with inspiration because right-sided blood flow increases when you take a breath. In isolated pulmonic stenosis, the jugular venous pressure is usually normal, since the obstruction is at the pulmonary outflow and does not by itself raise right atrial pressures. So hearing the murmur in the left upper sternal border around the 2nd to 3rd interspaces with a normal JVP fits pulmonic stenosis. The other options place the murmur in locations or contexts that don’t match this lesion—for example, a murmur at the apex in diastole suggests a different valve problem, left-sided valve disease isn’t the source here, and a prone position isn’t typical for this outflow obstruction.