Mean Percentage Score by Clinical Scenario Harvey Clinical Scenarios Pretest Post-test Normal (extra heart sounds - S3, S4) Aortic 49% 100% Pulmonary 8% 89% Tricuspid 10% 72% Mitral 8% 82% Systolic Murmur (innocent murmur, mitral prolapse) Aortic 44% 100% Pulmonary 1% 89% Tricuspid 6% 64% Mitral 35% 96% Diastolic Murmur
(chronic AR and acute AR) Aortic 31% 100% Pulmonary 3% 81% Tricuspid 6% 76% Mitral 46% 93% Overall Percentage Scores Aortic 41% 100% Pulmonary 4% 86% Tricuspid 7% 71% Mitral 30% 90% Note.
Grade I/VI mild, faint diastolic murmur
heard best at the left lower sternal border was present.
Cardiovascular examination showed a water-hammer pulse (Corrigan's sign), prosthetic heart sounds, an ejection systolic murmur, and an early diastolic murmur
consistent with aortic regurgitation.
Physical examination revealed a 2/6 diastolic murmur
Physical examination revealed rales at both lung bases and a new diastolic murmur
at the aortic site, with absence of the metallic click.
There was now a grade 4/6 systolic murmur consistent with aortic stenosis, a grade 3/6 diastolic murmur
consistent with aortic insufficiency, and a grade 1-2/6 diastolic murmur
consistent with functional mitral stenosis (a so-called Austin Flint murmur).