Systolic Murmurs
Systolic Murmurs - Related Videos
07:13
A Rat Model of Pressure Overload Induced Moderate Remodeling and Systolic Dysfunction as Opposed to Overt Systolic Heart Failure
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Cited by 1 •
2020
We describe the creation of a rat model of pressure overload induced moderate remodeling and early systolic dysfunction where signal transduction pathways involved in the initiation of the remodeling process are activated. This animal model will aid in identifying molecular targets for applying early therapeutic anti-remodeling strategies for heart failure.
10:51
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.
10:20
Right Ventricular Systolic Pressure Measurements in Combination with Harvest of Lung and Immune Tissue Samples in Mice
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Cited by 17 •
2013
A specific and rapid protocol to simultaneously investigate right heart function, lung inflammation, and the immune response is described as a learning tool. Video and figures describe physiology and microdissection techniques in an organized team-approach that is adaptable to be used for small to large sized studies.
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...
15:58
Using Point of Care Ultrasound to Augment Acquisition of Physical Exam Skills: Organs
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2023
Source: Joseph H. Donroe, Rachel Liu; Yale School of Medicine, USA Point of care ultrasound (POCUS) is used by clinicians for diagnosis, ongoing monitoring, and/or procedural guidance at the time of patient care. Many medical schools are now teaching POCUS as a part of their basic clinical skills training, in addition to history, physical exams, and clinical reasoning. Besides being an independent skill, POCUS is also an incredibly useful tool for augmenting the teaching and learning of the...
FAQs
Turbulence during ventricular contraction creates vibrations in cardiac structures, producing an audible murmur. Increased flow can generate these vibrations without a narrowed or incompetent valve, whereas obstruction through a narrowed valve or backward flow through an incompetent valve reflects a structural disturbance. Distinguishing the underlying flow pattern helps clinicians decide whether the finding may be innocent or clinically significant.
The murmur’s timing and shape provide clues about how blood moves during contraction. A crescendo-decrescendo pattern, an early systolic sound, and a holosystolic sound represent different acoustic patterns that can support clinical interpretation. These features are not considered in isolation; clinicians combine them with intensity, location, radiation, and responses to maneuvers.
A murmur’s response to bedside maneuvers adds physiologic context to the initial sound. Changes observed during these maneuvers can help distinguish an innocent finding from one associated with structural heart disease. Because the assessment also includes timing, intensity, location, and radiation, maneuver responses function as one part of a broader clinical pattern rather than a standalone diagnosis.
Clinicians distinguish these possibilities by integrating several auscultatory characteristics rather than relying on the presence of a murmur alone. Intensity, location, radiation, timing, shape, and maneuver response help identify patterns more suggestive of structural disease. This distinction matters because structural abnormalities may affect cardiac output and long-term cardiovascular risk, while some murmurs may not indicate such disease.
A focused assessment records when the sound occurs between S1 and S2, how loud it is, where it is heard most clearly, whether it radiates, and how it changes with maneuvers. The clinician also considers whether the pattern is crescendo-decrescendo, early, or holosystolic. Together, these observations guide the next step in evaluation.
Auscultation findings help determine whether additional evaluation is appropriate, particularly when the pattern raises concern for structural heart disease. Depending on the clinical assessment, follow-up may include echocardiography, monitoring, or treatment planning. These decisions are important because valve narrowing or incompetence can influence cardiac output and contribute to longer-term cardiovascular risk.