Clinical Findings in Heart Failure

A 70 year old man with a 35 year history of hypertension, dyslipidemia, and a 20 year history of type 2 diabetes presents. He was recently diagnosed with systolic heart failure, presenting with dyspnea on exertion and orthopnea. Prior clinical assessment revealed the murmur of mitral regurgitation. Which of the following would the NP anticipate finding on today’s physical exam?  

A. A mid to late systolic murmur that follows a mid systolic click. 

B. In early to mid systolic murmur harsh in quality, that radiates to the neck. 

C. A holosystolic murmur that radiates to the axilla.

D. A localized mid to late diastolic murmur.

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