Diagram of physical findings in a patient with aortic stenosis and mitral regurgitation

Murmur, character, intensity, and radiation are depicted. Sound of pulmonic closure exceeds that of aortic closure. Left ventricular (LV) thrust and right ventricular (RV) lift (heavy arrows) are identified. A 4th heart sound (S₄) and systolic thrill (T_S) are present. a = aortic closure sound; p = pulmonic closure sound; S₁ = 1st heart sound; S₂ = 2nd heart sound; 3/6 = grade of crescendo-diminuendo murmur (radiates to both sides of neck); 2/6 =grade of pansystolic apical crescendo murmur; 1+ = mild precordial lift of RV hypertrophy (arrow shows direction of lift); 2+ = moderate LV thrust (arrow shows direction of thrust).