Chart — Cardiac
Valvular Heart Disorders Comparison Chart
The four lesions the exam loves, sorted by the underlying problem, the murmur and its timing, the hallmark findings, and the key nursing concern. Remember: stenosis = won’t open, regurgitation = won’t close.
Educational use only. Valve-disease management is individualized and provider-directed. This chart is an educational comparison aid. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Side by Side
| Lesion | Problem | Murmur (timing) | Hallmark findings | Nursing concern |
|---|---|---|---|---|
| Mitral stenosis (MS) | Narrowed mitral valve → blood backs up into LA & lungs | Diastolic rumble + opening snap (apex, bell) | Dyspnea, hemoptysis, atrial fibrillation, LA enlargement; often rheumatic | Anticoagulate for a-fib; manage pulmonary congestion |
| Mitral regurgitation (MR) | Leaky mitral valve → backflow into LA (volume overload) | Holosystolic blowing, radiates to axilla (apex) | Dyspnea, fatigue, LA/LV dilation; acute MR after MI papillary rupture | Monitor for heart failure; afterload reduction |
| Aortic stenosis (AS) | Narrowed aortic valve → LV pressure overload | Harsh systolic crescendo-decrescendo, radiates to carotids | SAD triad: Syncope, Angina, Dyspnea (exertional) | Preload-dependent — avoid aggressive diuresis/vasodilators; symptoms → valve replacement |
| Aortic regurgitation (AR) | Leaky aortic valve → backflow into LV (volume overload) | Diastolic blowing decrescendo (Erb's point, leaning forward) | Wide pulse pressure, bounding pulses, LV dilation | Monitor for heart failure; treat acute AR (e.g., endocarditis) urgently |
Exam Traps
- ✦Systolic murmurs = aortic stenosis + mitral regurgitation; diastolic = aortic regurgitation + mitral stenosis.
- ✦Aortic stenosis = SAD (Syncope, Angina, Dyspnea); symptom onset means it's time for valve replacement.
- ✦Mitral stenosis → atrial fibrillation and pulmonary congestion (classically rheumatic) → anticoagulate.
- ✦AS radiates to the carotids; MR radiates to the axilla.
- ✦Severe aortic stenosis is preload-dependent — avoid aggressive vasodilation/diuresis.
Related Resources
Standards & sources
Fact-checked Jun 20, 2026This page is written to align with American Heart Association (AHA) · American College of Cardiology (ACC) · AHA ACLS Guidelines. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →