Northwestern University Feinberg School of Medicine
Cardiac Module

Differential cases

Each case gives a short history and two possible diagnoses. Choose the exam techniques that would tell them apart, review the findings, and pick a diagnosis.

  1. Case 1

    Systolic murmur — AS vs MR

    A 68-year-old man presents with progressive shortness of breath on exertion and a recent episode of near-syncope while climbing stairs. On auscultation there is a systolic murmur. Is it aortic stenosis or mitral regurgitation?

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  2. Case 2

    Diastolic murmur — AR vs MS

    A 45-year-old woman presents with new-onset shortness of breath. On exam there is a diastolic murmur. Is it aortic regurgitation or mitral stenosis?

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  3. Case 3

    Extra heart sound — S3 vs S4

    A 72-year-old man with long-standing hypertension has two months of worsening shortness of breath on exertion. On auscultation there is an extra low-pitched sound in diastole. Is it an S3 or an S4?

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