Murmur and maneuver

4 big rules are all u have to remember
1) Preload = more blood more murmur, less blood less murmur
- Except MVP, MR and HOCM
- In MR, more blood SAME murmur, less blood less murmur
- MVP and HOCM more blood LESS murmur, less blood MORE murmur

2) Afterload
- Inverse relationship with EJECTION murmur - more afterload less ejection murmur and vice versa
- Direct relationship with REGURGITATION murmur - more afterload more regurgitation murmur

3) Inspiration increases all right sided murmur except ejection murmur ( PS )

4) Expiration increases ALL left sided murmur except MVP, MR and HOCM ( rule #1 applies )