A site for medical students - Practical,Theory,Osce Notes

Heart murmurs (Systolic and Diastolic murmur)

Heart murmurs are relatively prolonged series of auditory vibrations of variable intensity,quality as well as frequency.
Heart murmurs are produced due to turbulence when there is increased blood flow or due to flow through a constricted or irregular orifice.

Description of a murmur

  1. Area over precordium where murmur best heard
  2. Systolic or diastolic
  3. Timing and character
  4. Intensity
  5. Pitch
  6. Bell/diaphragm
  7. Conduction
  8. Variation with respiration
  9. Best heard posture
  10. Variation with dynamic auscultation

Levine and freema’s grading of murmur
Systolic murmur

  1. Very soft [heard in a quiet room]
  2. Soft
  3. Moderate
  4. Loud with thrill
  5. Very loud with thrill [heard with stethoscope]
  6. Very loud with thrill [heard even when stethoscope is slightly away from chest wall].
Diastolic murmur

  1. Very soft
  2. Soft
  3. Loud
  4. Loud with thrill