effect of posture

Last reviewed 01/2018

  • left lateral position: accentuates murmurs of mitral valve disease
  • when sitting up: accentuates aortic murmurs, ejection clicks, pericardial rub
  • lying down: functional murmurs are accentuated when the patient is lying down
  • Valsalva manouevre: the murmur of mitral regurgitation or aortic stenosis becomes softer during the Valsava manouevre. This manouevre causes murmurs of mitral valve prolapse and hypertrophic obstructive cardiomyopathy to become louder. If a patient squats promptly then this has the reverse effects to those occurring in the Valsalva manouevre.
  • If the patient has a venous hum then this is only heard when the patient is upright. The murmur is accentuated when the patient turns his head away from the side being examined.