Murmur: Difference between revisions
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== Description == |
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=== Location === |
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* Aortic valve/right upper sternal border: second intercostal space at the right sternal border |
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* Pulmonary valve/left upper sternal border: second intercostal space at the left sternal border |
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* Tricuspid valve/left lower sternal border: fourth intercostal space at the left sternal border |
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* Mitral valve/point of maximal impulse/apex: approximately the fifth intercostal space at the left midclavicular line |
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* Radiation |
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===Intensity=== |
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{| class="wikitable" |
{| class="wikitable" |
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!Grade |
!Grade |
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=== Quality === |
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* High or low frequency |
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* Blowing, harsh, musical, rumbling, squeaky |
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=== Profile === |
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* Crescendo, decrescendo, crescendo-decrescendo, or plateau |
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=== Timing === |
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* Systolic, diastolic |
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* Early, mid, or late |
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* Holosystolic |
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== Interpretation == |
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{| class="wikitable sortable mw-collapsible" |
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! rowspan="2" |Valvulopathy |
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! colspan="5" |Description |
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! colspan="5" |Maneuvers |
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! colspan="3" |Position |
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|- |
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!Location |
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!Radiation |
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!Timing |
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!Quality |
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!Profile |
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!Inspiration |
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!Isometric Handgrip (β Afterload) |
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!Squatting (β Preload) |
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!Valsalva (β Preload) |
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!Release Valsalva |
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!Left Lateral Decubitus |
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!Learning Forward |
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!Supine |
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|Innocent |
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|LSB |
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|Β±apex |
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|mid-systolic |
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|musical, vibratory |
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|β |
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|β |
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|[[Aortic regurgitation]] |
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|LLSB or PMI |
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|Β±LUSB |
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|diastolic |
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|blowing |
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|D |
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|β |
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|β |
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|β |
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|β |
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|β |
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|β³[[Austin Flint murmur|Austin Flint]] |
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|PMI |
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|mid-diastolic |
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|rumble |
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|[[Aortic stenosis]] |
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|RUSB |
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|Β±carotids |
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|mid-systolic |
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|C-D |
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|β |
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|β |
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|β |
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|β |
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|β |
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|[[Mitral regurgitation]] |
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|PMI |
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|Β±left axilla |
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|holosystolic |
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|β |
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|β |
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|β |
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|β |
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|β |
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|[[Mitral valve prolapse]] |
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|PMI |
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|early systolic |
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|click |
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|β |
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|β |
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|β |
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|β |
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|[[Mitral stenosis]] |
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|PMI |
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|mid-diastolic |
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|Β±OS, loud S1, rumble |
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|D |
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|β |
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|β |
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|β |
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|β |
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|[[Pulmonic regurgitation]] |
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|β |
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|β |
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|[[Pulmonic stenosis]] |
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|LUSB |
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|systolic |
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|C-D |
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|β |
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|β |
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|[[Tricuspid regurgitation]] |
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|LLSB |
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|systolic |
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|β |
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|[[Tricuspid stenosis]] |
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|LLSB |
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|diastolic |
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|β |
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|β |
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|β |
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|[[Atrial septal defect]] |
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|LUSB |
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|may be harsh; fixed split S2 |
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|[[Ventricular septal defect]] |
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|PMI |
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|holosystolic |
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|loud, high-pitched, harsh |
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|β |
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|β |
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|[[Hypertrophic obstructive cardiomyopathy]] |
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|PMI to LLSB |
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|mid-systolic |
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|harsh |
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|C-D |
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|β |
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|β |
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|β |
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|[[Patent ductus arteriosus]] |
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|LUSB |
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|continuous |
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|machine-like |
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[[Category:Clinical exam]] |
[[Category:Clinical exam]] |
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[[Category:Cardiology]] |
[[Category:Cardiology]] |
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Latest revision as of 17:33, 15 March 2022
Description
Location
- Aortic valve/right upper sternal border: second intercostal space at the right sternal border
- Pulmonary valve/left upper sternal border: second intercostal space at the left sternal border
- Tricuspid valve/left lower sternal border: fourth intercostal space at the left sternal border
- Mitral valve/point of maximal impulse/apex: approximately the fifth intercostal space at the left midclavicular line
- Radiation
Intensity
| Grade | Description |
|---|---|
| Grade 1 | Faintest sound that can be detected |
| Grade 2 | Soft murmur that is readily detectable |
| Grade 3 | Louder than grade 2 but not associated with a palpable thrill |
| Grade 4 | Associated with a palpable thrill |
| Grade 5 | Audible with stethoscope placed lightly on the chest |
| Grade 6 | Audible with stethoscope off the chest |
Quality
- High or low frequency
- Blowing, harsh, musical, rumbling, squeaky
Profile
- Crescendo, decrescendo, crescendo-decrescendo, or plateau
Timing
- Systolic, diastolic
- Early, mid, or late
- Holosystolic
Interpretation
| Valvulopathy | Description | Maneuvers | Position | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Location | Radiation | Timing | Quality | Profile | Inspiration | Isometric Handgrip (β Afterload) | Squatting (β Preload) | Valsalva (β Preload) | Release Valsalva | Left Lateral Decubitus | Learning Forward | Supine | |
| Innocent | LSB | Β±apex | mid-systolic | musical, vibratory | β | β | |||||||
| Aortic regurgitation | LLSB or PMI | Β±LUSB | diastolic | blowing | D | β | β | β | β | β | |||
| β³Austin Flint | PMI | mid-diastolic | rumble | ||||||||||
| Aortic stenosis | RUSB | Β±carotids | mid-systolic | C-D | β | β | β | β | β | ||||
| Mitral regurgitation | PMI | Β±left axilla | holosystolic | β | β | β | β | β | |||||
| Mitral valve prolapse | PMI | early systolic | click | β | β | β | β | ||||||
| Mitral stenosis | PMI | mid-diastolic | Β±OS, loud S1, rumble | D | β | β | β | β | |||||
| Pulmonic regurgitation | β | β | |||||||||||
| Pulmonic stenosis | LUSB | systolic | C-D | β | β | ||||||||
| Tricuspid regurgitation | LLSB | systolic | β | ||||||||||
| Tricuspid stenosis | LLSB | diastolic | β | β | β | ||||||||
| Atrial septal defect | LUSB | may be harsh; fixed split S2 | |||||||||||
| Ventricular septal defect | PMI | holosystolic | loud, high-pitched, harsh | β | β | ||||||||
| Hypertrophic obstructive cardiomyopathy | PMI to LLSB | mid-systolic | harsh | C-D | β | β | β | ||||||
| Patent ductus arteriosus | LUSB | continuous | machine-like | ||||||||||
