Heart Murmurs*
Heart Murmurs*: Excerpt from A Pocket Manual of Differential Diagnosis
Systolic
Early systolic
Physiologic (innocent)
Small ventricular septal defect
Large ventricular septal defect with pulmonary hypertension
Severe acute mitral or tricuspid regurgitation
Tricuspid regurgitation without pulmonary hypertension
Midsystolic
Physiologic (innocent)
Vibratory murmur
Hyperkinetic states
Pulmonary ejection murmur
Aortic ejection murmur of old age
Obstruction to left ventricular outflow
Valvular aortic stenosis
Supravalvular aortic stenosis
Hypertrophic cardiomyopathy
Aortic valve prosthesis
Aortic dilatation
Murmurs of mitral regurgitation (occasionally)
Aortic flow murmur in aortic regurgitation
Coarctation of aorta
Supraclavicular arterial bruit
Obstruction to right ventricular outflow
Supravalvular pulmonary arterial stenosis
Pulmonic valvular stenosis
Subpulmonic (infundibular) stenosis
Flow murmur of atrial septal defect
Idiopathic dilatation of pulmonary artery
Pulmonary hypertension of any cause (occasionally)
Late systolic
Mitral valve prolapse
Tricuspid valve prolapse
Holosystolic
Mitral regurgitation
Tricuspid regurgitation secondary to pulmonary hypertension
Ventricular septal defect
Patent ductus arteriosus or aorticopulmonary window with pulmonary hypertension
Diastolic
Early diastolic
Aortic regurgitation
Pulmonic regurgitation associated with pulmonary hypertension, congenital or valvular disease
Middiastolic
Mitral stenosis
Mitral valve prosthesis
Tricuspid stenosis
Atrial myxoma
Left atrial ball-valve thrombus
Austin Flint murmur
Increased diastolic atrioventricular flow
Hyperkinetic states
Mitral and tricuspid regurgitation
Left-to-right shunt (e.g., ventricular septal defect)
Acute rheumatic valvulitis
Complete heart block
Coronary artery stenosis
Presystolic
Mitral stenosis
Tricuspid stenosis
Atrial myxoma
Left-to-right shunt
Complete heart block
Severe pulmonic stenosis
Fourth heart sound
Severe aortic insufficiency
Continuous
Pseudomurmur (e.g., pericardial friction rub)
Traumatic or surgical arteriovenous fistula
Patent ductus arteriosus
Surgically created aorticopulmonary fistula
Pulmonary arteriovenous fistula
Aorticopulmonary window without severe pulmonary
hypertension
Pulmonary embolism
Coronary arteriovenous fistula
Ruptured sinus of Valsalva aneurysm
Coarctation of aorta
Bronchial artery collateral circulation
Lutembacher's syndrome
Anomalous left coronary artery
Intercostal arteriovenous fistula
Cervical venous hum
Mammary souffle
Aortic arch syndrome
Pulmonary artery branch stenosis or partial occlusion
References
1. Craige E, Braunwald E: The Physical Examination, p. 35. See Bibliography, 1.
2. Williams ES: Essential Features of the Cardiac History and Physical Examination, p. 315. See Bibliography, 2.
3. Friedman HH: Cardiovascular Problems: Heart Murmurs, p. 74. See Bibliography, 4.
*See also 2-N.
Book Source Details
- Book Title: A Pocket Manual of Differential Diagnosis
- Author(s): Stephen N. Adler, Dianne B. Gasbarra
- Year of Publication: 1999
- Copyright Details: A Pocket Manual of Differential Diagnosis, Copyright © 1999 Lippincott Williams & Wilkins.
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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