How is physical exam of pt with MR?

Chronic severe MR (systolic murmur grade III/IV, holosystolic, systolic murmur usually prominent at apex and radiates to axilla) Acute severe MR (systolic murmur decrescendo and ceases mid to late systole) Ruptured chorodae tendina/ primary involvement of posterior mitral leaflet/prolapse/flail (regurg jet is eccentric directed anteriorly and strikes LA wall adjacent to aortic root, systolic murmur transmitted to base of heart)