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Classification of organic cardiac murmurs

Organic cardiac murmurs is of 3 types

  1. Systolic murmur
  2. Diastolic murmur
  3. Continuous murmur
Systolic murmurs can be

  1. Early systolic murmur
  2. Ejection systolic murmur (mid systolic murmur)
  3. Late systolic murmur
  4. Pansystolic murmur
I. Early systolic murmur 
They start with first heart sound (S1) and end before second heart sound. This murmur has decrescendo configuration.
Examples of early systolic murmurs are 
1.Ventricular septal defect
2.Acute mitral regurgitation
3.Acute tricuspid regurgitation

II. Ejection systolic murmur 
These murmur start after the S1 end before S2 with a crescendo – decrescendo configuration.
Examples of ejection systolic murmurs
1.Flow murmur
2.Systolic murmurs of ageing
3.Semilunar valve stenosis
4.Abnormal nonstenotic semilunar valve
5.Dilatation of vessel root
6.Outflow lead obstruction
7.Coarctation of aorta
Systolic murmur of ageing 
Called as 50/50 murmur. 50% adults above 50 years have this murmur.This is common in people with hypertension.
Murmur is produced due to aortic sclerosis.
Semilunar valve stenosis
Aortic stenosis
Pulmonary stenosis
Abnormal nonstenotic semilunar valve
Here functional murmurs occur due to increased cardiac stroke volume
Aortic regurgitation (AR)
Pulmonary regurgitation (PR)
Atrial septal defect (ASD)
Dilatation of  vessel root
Aortic dilatation
Pulmonary artery dilatation
Left ventricular outflow tract obstruction 
HOCM (Hypertrophic obstructive cardiomyopathy)

III.Late systolic murmur
These systolic murmurs start well after S1 and they extend into S2. These murmurs indicate mild degree of mitral regurgitation.
Examples are :
Mitral valve prolapse
Papillary muscle dysfunction

IV. Pansystolic murmur
They occur due to persistent pressure gradient produced due to abnormal structural or functional communication between two chambers of heart.
These murmurs start with S1 and extend into S2.
Causes are

  1. Mitral regurgitation
  2. Tricuspid regurgitation
  3. Ventricular septal defect