ALPHA
R(ight sided murmurs)
I(nspiration)
L(eft sided murmurs)
E(xpiration)
For IVDU, the first valve that the venous system interacts with is the tricuspid
Tricuspid valve regurgitation is where the valve between the two right heart chambers (right ventricle and right atrium) doesn't close properly. This causes a pan-systolic murmur best heard at the left lower sternal border and radiates to the right lower sternal border.
Mitral stenosis has a diastolic murmur which is of low pitch, rumbling in character, and best heard at the apex with the patient in the left lateral position. It commences after the opening snap of the mitral valve, and the duration of the murmur correlates with the severity of the stenosis.
Pulmonic regurgitation produces a soft, high-pitched, early diastolic decrescendo murmur heard best at the left upper sternal border there it is unlikely to be correct here.
Mitral regurgitation is described as a high-pitched pan-systolic murmur, best heard at the apex with the patient in the left lateral decubitus position.
Mitral valve prolapse is where blood leaks backward through the mitral valve in the heart. Its produces a mid-systolic click usually accompanied by a late systolic murmur.