Family Nurse Practitioner Exam

A 70-year-old male presents with a Grade II/VI murmur. What is a likely diagnosis?

1. Aortic stenosis

2. Mitral regurgitation

3. Tricuspid regurgitation

4. Pulmonary stenosis

The correct answer is: Mitral regurgitation

In evaluating a 70-year-old male with a Grade II/VI murmur, it is important to consider the typical characteristics and common causes of murmurs in this age group. A Grade II murmur is a soft sound that is easily audible but not very loud, which aligns with many pathologies that lead to moderate turbulence but not extreme flow changes. Mitral regurgitation is a common condition in the elderly and is characterized by a holosystolic murmur that is often best heard at the apex of the heart and may radiate to the left axilla. This type of murmur can be graded based on intensity, and in many cases, especially in older patients, a Grade II murmur fits the presentation of a moderate mitral regurgitation scenario. Additionally, age-related degenerative changes in the mitral valve, such as calcification or valve prolapse, can lead to this murmur. Other options like aortic stenosis or pulmonary stenosis typically present with specific bruit patterns and are often associated with higher-grade murmurs as the disease progresses. Aortic stenosis, in particular, usually has a stronger and more pronounced sound, particularly in older adults. Tricuspid regurgitation typically occurs as a result of right