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These include timing, shape, location, radiation, intensity, pitch and quality. [7] Timing refers to whether the murmur is a systolic, diastolic, or continuous murmur. Shape refers to the intensity over time. Murmurs can be crescendo, decrescendo or crescendo-decrescendo. Crescendo murmurs increase in intensity over time.
The resultant configuration of this murmur is a crescendo-decrescendo murmur. Causes of midsystolic ejection murmurs include outflow obstruction, increased flow through normal semilunar valves, dilation of aortic root or pulmonary trunk, or structural changes in the semilunar valves without obstruction.
The murmur heard in HCM (or HOCM, if obstructive) is a systolic ejection crescendo-decrescendo murmur. The intensity of this murmur can vary based on the degree of obstruction. This murmur can also change in intensity based on different maneuvers that can be accomplished with the body.
The murmur usually does not extend to S1. Early diastolic Left anterior descending artery stenosis This murmur, also known as Dock's murmur, is similar to that of aortic regurgitation and is heard at the left second or third intercostal space. A Coronary artery bypass surgery can eliminate the murmur. Early diastolic Cabot–Locke murmur
The murmur is louder during expiration but is also easily heard during inspiration. The more severe the degree of the stenosis, the later the peak occurs in the crescendo-decrescendo of the murmur. [33] The second heart sound (A 2) tends to become decreased and softer as the aortic stenosis becomes more severe. [24]
Patients with mitral valve prolapse may have a mid-systolic click along with a murmur, referred to as apical late systolic murmur. [3] Early systolic clicks may also be present in some patients. [4] Aortic and pulmonary stenosis may cause an ejection click [5] immediately after S 1.
The murmur is heard best with the bell of the stethoscope [16] lying on the left side [15] and its duration increases with worsening disease. [16] Advanced disease may present with signs of right-sided heart failure such as parasternal heave, jugular venous distension, hepatomegaly, ascites and/or pulmonary hypertension (presenting with a loud ...
A pansystolic heart murmur may be heard on auscultation of the chest. The murmur is usually of low frequency and best heard on the lower left sternal border. It increases with inspiration, and decreases with expiration: this is known as Carvallo's sign. However, the murmur may be inaudible due to the relatively low pressures in the right side ...