Cardiac ModuleFeinberg School of Medicine Phase 1 Cardiac Module

Stage 3

Three differential cases

Each case presents a vignette and a two-diagnosis differential. Select the exam techniques that would distinguish them, review the findings, and commit to a diagnosis.

Case 1Aortic stenosisMitral regurgitation
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, you hear a systolic murmur — but is it aortic stenosis or mitral regurgitation?
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Case 2Aortic regurgitationMitral stenosis
Diastolic murmur — AR vs MS
A 45-year-old woman presents with new-onset shortness of breath. On exam, you hear a diastolic murmur — is this aortic regurgitation or mitral stenosis?
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Case 3Aortic stenosisS3 gallop (heart failure)
Dyspnea with extra heart sound — AS vs S3 gallop
A 75-year-old man presents with progressive shortness of breath, orthopnea, and bilateral leg swelling. He has an extra heart sound on auscultation — is this aortic stenosis, or an S3 of heart failure?
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