A systolic murmur that transmits to the neck is typically of which origin?

• A. Pulmonary
• B. Mitral
• C. Tricuspid
• D. Aortic

Answer: (D)

Radiation pattern helps identify origin: a murmur heard in systole that radiates up toward the neck points to the aortic valve. The high‑velocity jet across the aortic valve travels along the arterial tree to the carotids, producing a sound best heard in the neck. That’s why this murmur is from the aortic valve, as seen in conditions like aortic stenosis or a flow murmur through the aortic valve. In contrast, mitral murmurs typically radiate to the axilla, tricuspid murmurs to the right heart borders, and pulmonary murmurs more toward the left upper sternal border or back, not prominently to the neck.