Innocent Murmur
Innocent Murmur - Related Videos
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Cardiac Exam III: Abnormal Heart Sounds
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2023
Source: Suneel Dhand, MD, Attending Physician, Internal Medicine, Beth Israel Deaconess Medical Center Having a fundamental understanding of normal heart sounds is the first step toward distinguishing the normal from the abnormal. Murmurs are sounds that represent turbulent and abnormal blood flow across a heart valve. They are caused either by stenosis (valve area too narrow) or regurgitation (backflow of blood across the valve) and are commonly heard as a "swishing" sound during auscultation.
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A Visual Guide for Studying Behavioral Defenses to Pathogen Attacks in Leaf-Cutting Ants
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We present a visual guide to disease defense behaviors in leaf-cutting ants, with individual clips and accompanying definitions, illustrated in an experimental infection scenario. Our main aim is to help other researchers recognize key defensive behaviors and to provide a common understanding for future research in this field.
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Holistic Facial Composite Creation and Subsequent Video Line-up Eyewitness Identification Paradigm
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This applied experimental paradigm replicates circumstances by which an eyewitness to a real crime may create a holistic facial composite of the culprit from memory, and then attempt to identify the culprit from a video line-up containing the culprit or one in which he or she is not present.
06:24
Cardiac Exam II: Auscultation
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2023
Source: Suneel Dhand, MD, Attending Physician, Internal Medicine, Beth Israel Deaconess Medical Center Proficiency in the use of a stethoscope to listen to heart sounds and the ability to differentiate between normal and abnormal heart sounds are essential skills for any physician. Correct placement of the stethoscope on the chest corresponds to the sound of cardiac valves closing. The heart has two main sounds: S1 and S2. The first heart sound (S1) occurs as the mitral and tricuspid valves...
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Proper Adjustment of Patient Attire during the Physical Exam
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2023
Source: Jaideep S. Talwalkar, MD, and Joseph Donroe, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT In order to optimize the predictive value of the physical examination, the provider must perform maneuvers correctly. The proper use of drapes is an important component of correctly performing physical examination maneuvers. Skin lesions are missed when "inspection" occurs through clothing, crackles are erroneously reported when the lungs are examined through a...
FAQs
Blood-flow velocity and turbulence can vary even when the heart and great vessels show no evidence of structural disease. Those normal or temporary changes alter how prominently the sound is heard during examination. This mechanism explains why the finding may appear more evident at one time and less prominent when the underlying flow conditions change.
Fever, anemia, pregnancy, and rapid growth are clinically relevant contexts because an innocent murmur may become more noticeable during them. The key point is not that these conditions establish structural disease, but that they can coincide with temporary or normal changes in blood-flow velocity and turbulence. Their presence therefore helps interpret when the sound is being heard.
An innocent murmur is interpreted without evidence of structural heart disease, whereas a murmur that does not fit this assessment may require further cardiac evaluation. Clinicians use timing, location, intensity, positional or activity response, history, and symptoms to decide whether the finding remains consistent with a benign pattern or needs closer assessment.
Timing, location, and intensity provide important descriptive information about the sound. Clinicians also consider whether it changes with position or activity, then interpret those observations alongside the patient’s history and symptoms. Taken together, these features help distinguish a finding compatible with normal or temporary flow variation from one that warrants additional attention.
Assessment begins during cardiovascular examination by characterizing the murmur’s timing, location, and intensity. Clinicians then observe its response to position or activity and review the patient’s history and symptoms. This combined approach is more informative than any single feature, helping determine whether the sound can be regarded as benign or should prompt further cardiac evaluation.
Recognition can reduce unnecessary testing when the examination and clinical context support a benign finding without evidence of structural heart disease. By considering flow-related variation together with the murmur’s characteristics, history, and symptoms, clinicians can avoid treating every detected sound as evidence of disease while still identifying findings that do not fit the expected pattern.
The topic connects cardiovascular examination with the biology of blood flow: changes in velocity and turbulence can produce an audible finding even without structural disease. It also illustrates how physiological context affects observation, since fever, anemia, pregnancy, and rapid growth may alter when the sound becomes noticeable. This supports more accurate interpretation of examination findings.