Murmur: Difference between revisions
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β | == |
+ | == Description == |
+ | |||
+ | === Location === |
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+ | |||
+ | * Aortic valve: second intercostal space at the right sternal border |
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+ | * Pulmonary valve: second intercostal space at the left sternal border |
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+ | * Tricuspid valve: fourth intercostal space at the left sternal border |
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+ | * Mitral valve: fifth intercostal space at the left midclavicular line |
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+ | * Radiation: Murmurs may radiate, allowing auscultation at remote locations |
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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" |
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+ | |+ |
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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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+ | |- |
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+ | |Flow murmur |
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+ | | |
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+ | | |
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+ | |mid-systolic |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | |- |
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+ | |[[Aortic regurgitation]] |
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+ | |LLSB |
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+ | | |
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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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+ | | |
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+ | |β |
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+ | |- |
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+ | |Aortic regurgitation, Austin Flint |
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+ | |PMI |
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+ | | |
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+ | |mid-diastolic |
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+ | |rumble |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | |- |
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+ | |[[Aortic stenosis]] |
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+ | |RUSB |
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+ | |Β±carotids |
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+ | |systolic |
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+ | | |
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+ | |C-D |
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+ | |β |
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+ | | |
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+ | |β |
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+ | |β |
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+ | |β |
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+ | |- |
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+ | |[[Mitral regurgitation]] |
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+ | |PMI |
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+ | |Β±axillae |
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+ | |systolic |
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+ | | |
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+ | | |
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+ | |β |
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+ | |β |
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+ | |β |
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+ | |β |
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+ | | |
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+ | |- |
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+ | |[[Mitral valve prolapse]] |
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+ | | |
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+ | | |
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+ | |early systolic |
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+ | |click |
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+ | | |
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+ | |β |
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+ | |β |
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+ | |β |
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+ | |β |
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+ | | |
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+ | |- |
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+ | |[[Mitral stenosis]] |
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+ | |PMI |
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+ | | |
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+ | |diastolic |
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+ | | |
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+ | | |
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+ | |β |
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+ | | |
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+ | |β |
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+ | |β |
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+ | | |
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+ | |- |
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+ | |[[Pulmonic regurgitation]] |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | |β |
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+ | | |
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+ | | |
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+ | | |
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+ | |β |
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+ | |- |
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+ | |[[Pulmonic stenosis]] |
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+ | |LUSB |
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+ | | |
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+ | |systolic |
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+ | | |
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+ | |C-D |
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+ | |β |
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+ | | |
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+ | | |
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+ | | |
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+ | |β |
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+ | |- |
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+ | |[[Tricuspid regurgitation]] |
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+ | |LLSB |
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+ | | |
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+ | |systolic |
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+ | | |
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+ | | |
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+ | |β |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | |- |
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+ | |[[Tricuspid stenosis]] |
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+ | |LLSB |
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+ | | |
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+ | |diastolic |
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+ | | |
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+ | | |
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+ | |β |
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+ | | |
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+ | | |
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+ | |β |
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+ | |β |
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+ | |- |
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+ | |[[Atrial septal defect]] |
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+ | |LUSB |
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+ | | |
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+ | | |
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+ | |may be harsh; fixed split S2 |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | |- |
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+ | |[[Ventricular septal defect]] |
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+ | |PMI |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | |β |
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+ | | |
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+ | |β |
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+ | | |
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+ | |- |
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+ | |[[Hypertrophic obstructive cardiomyopathy]] |
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+ | |PMI to LLSB |
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+ | | |
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+ | |systolic |
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+ | | |
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+ | | |
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+ | | |
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+ | |β |
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+ | |β |
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+ | |β |
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+ | | |
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+ | |- |
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+ | |[[Patent ductus arteriosus]] |
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+ | |LUSB |
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+ | | |
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+ | |continuous |
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+ | |machine-like |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | | |
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+ | |} |
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[[Category:Clinical exam]] |
[[Category:Clinical exam]] |
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[[Category:Cardiology]] |
[[Category:Cardiology]] |
Revision as of 13:19, 15 March 2022
Description
Location
- Aortic valve: second intercostal space at the right sternal border
- Pulmonary valve: second intercostal space at the left sternal border
- Tricuspid valve: fourth intercostal space at the left sternal border
- Mitral valve: fifth intercostal space at the left midclavicular line
- Radiation: Murmurs may radiate, allowing auscultation at remote locations
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
Location | Radiation | Timing | Quality | Profile | Inspiration | Isometric Handgrip (β Afterload) | Squatting (β Preload) | Valsalva (β Preload) | Release Valsalva | |
---|---|---|---|---|---|---|---|---|---|---|
Flow murmur | mid-systolic | |||||||||
Aortic regurgitation | LLSB | diastolic | blowing | D | β | β | β | β | ||
Aortic regurgitation, Austin Flint | PMI | mid-diastolic | rumble | |||||||
Aortic stenosis | RUSB | Β±carotids | systolic | C-D | β | β | β | β | ||
Mitral regurgitation | PMI | Β±axillae | systolic | β | β | β | β | |||
Mitral valve prolapse | early systolic | click | β | β | β | β | ||||
Mitral stenosis | PMI | diastolic | 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 | β | β | |||||||
Hypertrophic obstructive cardiomyopathy | PMI to LLSB | systolic | β | β | β | |||||
Patent ductus arteriosus | LUSB | continuous | machine-like |