A 55-year-old woman with rheumatic heart disease has a diastolic murmur best heard at the apex. At which surface marking should the stethoscope be placed to auscultate the mitral valve?
- A Left 5th intercostal space, medial to the midclavicular line
- B Left 5th intercostal space at the midclavicular line ✓
- C Left 4th intercostal space just lateral to the sternum
- D Right 2nd intercostal space close to the sternum
Correct answer: B. Left 5th intercostal space at the midclavicular line
Explanation
The mitral valve is auscultated at the cardiac apex, which normally lies in the left 5th intercostal space at or just medial to the midclavicular line, where the heartbeat is felt as the apex beat. Option C is the pulmonary area, option D is the aortic area, and option A describes an apex shifted medially rather than the standard landmark. Indian textbooks consistently teach the apex as the mitral auscultation point.
Reference: Gray's Anatomy for Students, 4th ed.
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Written and medically reviewed by the StethoPrep medical team.