Pansystolic murmurs can be seen in which conditions?

• A. MVR, TVR and inflammation of the parietal pericardium from pericarditis
• B. Aortic stenosis and pulmonary embolism
• C. Atrial myxoma
• D. Hypertrophic cardiomyopathy

Answer: (A)

Pansystolic (holosystolic) murmurs are heard throughout the entire systole, from S1 to S2, and arise when there is regurgitant flow across a valve or a septal defect. The classic situations produce this murmur pattern because blood moves backward during the whole of systole. Mitral regurgitation and tricuspid regurgitation are textbook causes: each creates a blowing, uniform murmur best heard over the apex or left lower sternal border, respectively, extending from the start of systole to the end of it. A ventricular septal defect also yields a holosystolic murmur along the left sternal border as blood shunts left to right throughout systole.

In the given options, the symptoms align with regurgitant lesions—mitral regurgitation and tricuspid regurgitation—making this choice the best match for pansystolic murmurs. Pericardial inflammation from pericarditis, by contrast, typically causes a friction rub rather than a pansystolic murmur. Aortic stenosis and pulmonary embolism generate different systolic murmur patterns, atrial myxoma can present with non-holosystolic murmurs, and hypertrophic cardiomyopathy produces a dynamic systolic murmur not holosystolic.