OnExam

This manoeuvre can be utilized to differentiate between aortic stenosis, mitral valve prolapse and hypertrophic cardiomyopathy

Performing the Test

  1. Securely fasten patient gown and have them use the exam table for balance
  2. Squatting increases venous return, peripheral vascular resistance, stroke volume, blood pressure versus standing which has the opposing effects
  3. Auscultate during the squatting and standing phases
    • During squatting, mitral valve prolapse and hypertrophic cardiomyopathy = delay in click, and decrease in murmur intensity respectively
    • Aortic stenosis = increase in intensity of the murmur

References

  1. Bickley L, Hoekelman R. Bates’ Guide to Physical Examination and History Taking. Philadephia, Pa: Lippincott; 2009.