Medicine

A 25-year-old male who is IV drug user presents with a 3-week history of worsening lethargy and confusion. O/E- PR: 130bpm and BP: 120/80. CVS examination: raised JVP with large v-waves and a loud systolic murmur. A palpable, pulsatile liver is felt when hepato-jugular reflex is attempted. What type of murmur is most fitting with this patient's presentation?