The early diastolic murmur of aortic regurgitation is best heard along which location?

• A. Left sternal border
• B. Right sternal border
• C. Apex
• D. Base near the left heart border

Answer: (A)

Aortic regurgitation creates an early diastolic, high-pitched blowing murmur from blood rushing backward from the aorta into the left ventricle just after S2. It is best heard along the left sternal border because the regurgitant jet presses against the chest wall as it flows toward the left-sided heart structures, with the aortic valve area closest to this location. Clinically, you’ll often hear it most clearly at the third to fourth intercostal spaces along the left sternal border, and the murmur is accentuated when the patient sits up and leans forward with an exhale. The right sternal border, apex, or a base near the left heart border are less ideal for this diastolic murmur, which is why the left sternal border is the classic listening point.