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MURMURS

Characteristics of Systolic Murmurs
Mid-Systolic Ejection Murmurs
begin after the first heart sound when the ventricular pressure is high enough to open the valves. As ejection increases and decreases, so does the murmur



Normal Heart
Aortic Stenosis
Found in:
Aortic Stenosis
Pulmonary Valve Stenosis
Tetralogy of Fallot
Dilatation of the Proximal Pulmonary Artery
Atrial Septal Defect

Holosystolic Regurgitant Murmurs
occupies all of systole and continues as long as there is a sufficient pressure gradient across the incompetent orifice to generate a regurgitant flow



Normal Heart
Mitral Regurgitation
Found in:
Mitral Insufficiency
Tricuspid Insufficiency
Ventricular Septal Defect
Patent Ductus Arteriosus

Early Systolic Murmurs
begin with S1 rather than
after it. They end abruptly in early systole or mid-systole and are characteristic of certain types of VSDs, mitral or tricuspid regurgitation .


Normal Heart
Early Systolic Murmur
Found in:
Small VSD without Pulmonary Hypertension
Large VSD with Pulmonary Hypertension
Septal Perforation due to Myocardial Infarct
Acute Severe Mitral Regurgitation

Late Systolic Murmurs
begins about one third or halfway into systole. It is due to mitral insufficiency where the valve is competent during early systole but prolapses into the LA in late systole .


Normal Heart
Mitral Valve Prolapse
 
Found in:
Mitral Valve Prolapse Syndrome
Click-Murmur Syndrome

Systolic Arterial Murmurs
as a characteristic of peripheral vascular disease affecting the larger arteries, to narrowing of the pulmonary artery and its branches or coarctation of the aorta .
 


Coarctation of the Aorta
Found in:
Pulmonary Artery Narrowing
Coarctation of the Aorta
Bicuspid Aortic Valve
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