Murmur: Difference between revisions
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== Interpretation == |
== Interpretation == |
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β | {| class="wikitable" |
+ | {| class="wikitable sortable mw-collapsible" |
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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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!Location |
!Location |
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!Radiation |
!Radiation |
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!Valsalva (β Preload) |
!Valsalva (β Preload) |
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!Release Valsalva |
!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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β | |Flow murmur |
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β | | |
+ | |LSB |
+ | |Β±apex |
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|mid-systolic |
|mid-systolic |
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+ | |musical, vibratory |
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+ | |β |
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+ | |β |
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|[[Aortic regurgitation]] |
|[[Aortic regurgitation]] |
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β | |LLSB |
+ | |LLSB or PMI |
+ | |Β±LUSB |
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|diastolic |
|diastolic |
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|blowing |
|blowing |
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|β |
|β |
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+ | |β |
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β | | |
+ | |β³[[Austin Flint murmur|Austin Flint]] |
|PMI |
|PMI |
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|mid-diastolic |
|mid-diastolic |
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|rumble |
|rumble |
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|RUSB |
|RUSB |
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|Β±carotids |
|Β±carotids |
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β | |systolic |
+ | |mid-systolic |
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|C-D |
|C-D |
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|β |
|β |
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|β |
|β |
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+ | |β |
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+ | | |
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|[[Mitral regurgitation]] |
|[[Mitral regurgitation]] |
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|PMI |
|PMI |
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β | |Β± |
+ | |Β±left axilla |
+ | |holosystolic |
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β | |systolic |
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|β |
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+ | | |
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+ | |β |
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+ | | |
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|[[Mitral valve prolapse]] |
|[[Mitral valve prolapse]] |
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β | | |
+ | |PMI |
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|early systolic |
|early systolic |
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|β |
|β |
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|β |
|β |
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|PMI |
|PMI |
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β | |diastolic |
+ | |mid-diastolic |
+ | |Β±OS, loud S1, rumble |
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β | | |
+ | |D |
|β |
|β |
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|β |
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+ | |β |
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|β |
|β |
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|[[Pulmonic stenosis]] |
|[[Pulmonic stenosis]] |
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|β |
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|[[Tricuspid regurgitation]] |
|[[Tricuspid regurgitation]] |
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|β |
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|β |
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|[[Atrial septal defect]] |
|[[Atrial septal defect]] |
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|may be harsh; fixed split S2 |
|may be harsh; fixed split S2 |
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|PMI |
|PMI |
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+ | |holosystolic |
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+ | |loud, high-pitched, harsh |
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|PMI to LLSB |
|PMI to LLSB |
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β | |systolic |
+ | |mid-systolic |
+ | |harsh |
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β | | |
+ | |C-D |
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|β |
|β |
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|β |
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|β |
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|continuous |
|continuous |
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|machine-like |
|machine-like |
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Revision as of 13:31, 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
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 |