What is the cause of a systolic murmur radiating to the right clavicle?

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Differential Diagnosis for Systolic Murmur Radiating to Right Clavicle

  • Single Most Likely Diagnosis
    • Aortic stenosis: This condition is characterized by the narrowing of the aortic valve opening, which can cause a systolic murmur that radiates to the right clavicle due to the direction of turbulent blood flow. The murmur is typically harsh and crescendo-decrescendo in nature.
  • Other Likely Diagnoses
    • Pulmonary stenosis: Although less common, pulmonary stenosis can also produce a systolic murmur that radiates to the back or the right clavicle, depending on the severity and location of the obstruction.
    • Hypertrophic cardiomyopathy: This condition can cause a systolic murmur due to dynamic left ventricular outflow tract obstruction, which may radiate to the clavicles.
  • Do Not Miss Diagnoses
    • Aortic dissection: Although less likely, aortic dissection can present with a new systolic murmur due to aortic regurgitation and should be considered in the differential diagnosis, especially in patients with risk factors such as hypertension or aortic aneurysm.
    • Endocarditis: Infective endocarditis can cause new murmurs, including systolic murmurs, due to valve destruction or vegetation formation, and is a critical diagnosis not to miss due to its high morbidity and mortality.
  • Rare Diagnoses
    • Supravalvular aortic stenosis: A rare congenital condition characterized by narrowing of the aorta above the aortic valve, which can cause a systolic murmur radiating to the right clavicle.
    • Sinus of Valsalva aneurysm: A rare condition where an aneurysm of the sinus of Valsalva can cause a systolic murmur due to aortic regurgitation or obstruction, which may radiate to the clavicles.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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