Cardiovascular Medicine Book

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Heart MurmurAka: Heart Murmur Interpretation

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  1. See Also
    1. Systolic Murmur
    2. Diastolic Murmur
    3. Pediatric Murmur
  2. Characteristics
    1. Identify beginning of systole and diastole
      1. S1 Heart Sound
      2. S2 Heart Sound
  3. Timing
    1. Determine timing of murmur
      1. Systolic Murmur
      2. Diastolic Murmur
    2. Determine Early, Middle or late in interval
  4. Severity
    1. Grade 1/6: Barely audible
    2. Grade 2/6: Just easily audible
    3. Grade 3/6:
    4. Grade 4/6:
    5. Grade 5/6: Loudest requiring a stethoscope
    6. Grade 6/6: Heard with stethoscope off chest
  5. Location
    1. Identify valve area involved
  6. Pattern
    1. Uniform: Constant
    2. Crescendo: Increasing
    3. Decrescendo (Diminuendo): Decreasing
    4. Crescendo-Decrescendo: Diamond Shaped Murmur
  7. Pitch
    1. Low pitched
      1. Best heard with bell chest-piece at light pressure
    2. High pitched
      1. Best heard with diaphragm at firm pressure
  8. Dynamic Maneuvers
    1. Position
      1. Supine
      2. Erect
      3. Left lateral decubitus position
    2. Exercise
  9. Interpretation
    1. Benign murmur findings
      1. Murmur characteristics
        1. Crescendo-decrescend character
        2. Musical or vibratory murmur
        3. Quiet murmur (Grade 2 or less)
        4. Timing: Early systolic or mid Systolic Murmur
        5. Location: Left sternal border or pulmonic area
      2. Associated findings absent
        1. Cardiopulmonary symptoms absent
        2. Family History absent
        3. Exam (BP, pulse, auscultation) otherwise normal
        4. Normal physiologic split S2 without gallup or click
    2. Pathologic murmur findings
      1. Murmur characteristics
        1. Timing: Diastolic, mid-late systolic, holosystolic
        2. Loud murmur (Grade 3 or greater)
        3. Murmur exacerbated by valsalva maneuver
        4. Murmur radiates to carotid artery or axilla
      2. Associated findings present
        1. Arrhythmia present
        2. Symptoms: Chest Pain, Palpitation, Dyspnea, Syncope
        3. Sudden Cardiac Death Family History
        4. Jugular Venous Pulsation abnormal
        5. Arterial pulsation abnormal
          1. Wide Pulse Pressure
          2. Water-Hammer Pulse (rapidly rising, bounding)
          3. Weak, slow rising pulse
        6. Other abnormal precordial exam
          1. Other heart sounds (e.g. Loud S1, fixed split S2)
          2. Left ventricular heave

Heart murmur (C0018808)

Definition (MSH)Heart sounds caused by vibrations resulting from the flow of blood through the heart. Heart murmurs can be examined by HEART AUSCULTATION, and analyzed by their intensity (6 grades), duration, timing (systolic, diastolic, or continuous), location, transmission, and quality (musical, vibratory, blowing, etc).
ConceptsClinical Attribute (T201)
ICD9785.2
MSHD006337
BasqueBIHOTZ PUTZALDIA EZ
DanishHjertemislyd INA
DutchHartgeruis NAO
EnglishCardiac Murmur, Cardiac Murmurs, Finding of heart murmur, Heart murmur, Heart murmurs, Murmur, Observation of heart murmur
FinnishSIVUAANI SYDAMESSA NUD
FrenchSouffle cardiaque NP
GermanHerzgeraeusch NNB
Hebrewivsha balev
ItalianSoffi cardiaci NSA
NorwegianHJERTE FREMMED-/BILYDER INA
PortugueseSopro cardiaco NE
Spanishhallazgo de soplo, murmullo, murmullo cardiaco, soplo, soplo cardiaco, soplo del corazon, soplos cardiacos
SwedishHJARTBILJUD UNS
Parent ConceptsHeart (C0018787), Cardio-vascular Findings: Heart (C0150873), Heart Diseases (C0018799), circulatory system (C0497231), Diagnosis/Diseases Component (C0497531), Signs and Symptoms (C0037088), Heart valve disease (C0018824), Heart murmur (C0018808), [D]Cardiovascular system symptoms (C0476270), Finding of heart sounds (C0577816), Duplicate concept (C1274013), Cardiac feature (C1285816), Finding by auscultation (C1290911)
SourcesAIR, AOD, COSTAR, DXP, ICPC, ICPCBAQ, ICPCDAN, ICPCDUT, ICPCFIN, ICPCFRE, ICPCGER, ICPCHEB, ICPCHUN, ICPCITA, ICPCNOR, ICPCPOR, ICPCSPA, ICPCSWE, LCH, MEDLINEPLUS, MSH, MTH, MTHICD9, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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