Differential diagnosis

Possible conditions in the differential diagnosis for mitral regurgitation include:

• aortic stenosis - an aortic ejection murmur of aortic stenosis may be maximal at the apex but finishes before A2 (note that A2 may disappear with valve calcification). The other characteristic features of aortic stenosis (slow-rising carotid pulse, greater left ventricular hypertrophy and calcium in the aortic valve) differentiate it from mitral regurgitation
  
  
• ventricular septal defect - in this condition the pansystolic murmur is maximal at the tricuspid area
  
  
• tricuspid regurgitation - there is an inspiratory pansystolic murmur at the fourth left interspace