Rosh Emergency Medicine Practice Test 2025 – 400 Free Practice Questions to Pass the Exam

The described murmur is characterized by a loud first heart sound, an opening snap, and a low-pitched diastolic rumble, which aligns perfectly with the features of a mitral stenosis murmur. In mitral stenosis, the stiffened mitral valve leaflets open with difficulty during diastole, leading to the distinct 'opening snap' after the second heart sound, followed by a rumbling sound that is best heard in the left lateral decubitus position. This rumble occurs due to turbulent blood flow across the narrowed valve, producing the classic low-pitched diastolic murmur associated with this condition.

The other options describe different types of murmurs that do not correspond with the specific features mentioned in the question. Each type has its own unique characteristics that do not match the key elements of a loud first heart sound, an opening snap, and a low-pitched diastolic rumble. Therefore, option C stands out as the correct representation of the murmur in question, directly linking it to the pathophysiology of mitral stenosis.