Systolic Murmur

This systolic murmur category will help you to learn about systolic murmurs including an innocent murmur, aortic sclerosis, aortic stenosis, mitral regurgitation, mitral valve prolapse, and hypertrophic cardiomyopathy.

systolic heart murmurs are the heart murmurs heard during systole. It begins during or after the first heart sound and ends before during the second heart sound.

Before you take this session you should have finished the normal heart sounds session, first heart sound, second heart sound sessions, and extra heart sounds (S3 & S4). You should feel gratified with your ability to listen and be familiar with normal heart sounds.

Please use good quality headphones or earphones. Computer or phones speakers often fail to reproduce some heart sounds.

Systolic murmurs Ejection systolic murmurs are caused by increased stroke volume (flow murmur), or stenosis of the aortic or pulmonary valve. An ejection murmur is also a feature of hypertrophic cardiomyopathy and is accentuated by exercise.

Aortic valve sclerosis is defined as calcification and thickening of the tri-leaflet aortic valve in the absence of obstruction of ventricular outflow.
Aortic stenosis is one of the most common and most serious valve disease problems. It is a narrowing of the aortic valve opening restricting the blood flow from the left ventricle to the aorta.

Mitral regurgitation is the oozing of blood backward through the mitral valve each time the left ventricle contracts.

Hypertensive cardiomyopathy is a structural cardiac disorder generally accompanied by concentric left ventricular hypertrophy associated with diastolic or systolic dysfunction in patients with persistent systemic hypertension (HTN)

In the medical practices, correct diagnosis and understanding of the case are important. So, while doing auscultation hearing the sounds correctly and identify the abnormalities in it is important.

Having prior practice to the sound will be a plus point for you, as we can do better in things we are familiar with. So, this site will be a friend for you in gaining practice in auscultation and learning different cases regarding it.

So, practice as much u want and gain your self-confidence, and help for your future practices. This site will always be a friend in need in case of learning about heart sounds.

Innocent murmurs

Innocent heart murmurs are harmless blood noises, which usually flow in the inner chambers of the heart.

These murmurings are founded in the lower left of the sternum.

They sound musical or have a distinctly pure sound.

This is most likely to happen between the ages of 3 and teenage hood.

Because they are low in pitch, a stethoscope is used for it to be best heard.

Aortic stenosis mild

 The aortic valve of the heart thinners mildly aortic stenosis occurs. 

This limitation prevents the valve from opening entirely, which restricts or blocks blood flow to your body (aorta) from your heart through and out of the main artery. 

There is also a loud murmuring in the systole early. When viewed in the phonocardiogram, it has a diamond-like appearance that comes when the murmur increases in tone. 

The whisper is marked by a frequent VI that offers a cooing musical quality to the murmur.

Aortic stenosis – severe 2

Aortic stenosis is a condition in which there is an obstruction of blood flow across the aortic valve. Severe aortic stenosis is the condition in which the aortic valve undergoes stenosis.

The leaflets of the valves become thick and hard to open. This transfers more workload to the heart to pump blood. Daily life activities are limited in case of severe aortic stenosis. Patients become tired faster. Failure of aortic valve surgery can cause aortic stenosis.

The calcium build-up also plays a significant role. Its symptoms include tiredness, dizziness, angina, and shortness of breath. On auscultation, the diamond-shaped systolic murmur is heard.

You can feel sluggish and exhausted over time. 

These may be symptoms of life threatening severe aortic stenosis. 

Studies have shown that, while many patients have no symptoms at first, 32% have symptoms after closer inspection. 

The first sound of the heart is normal. 

Physiologically, the second heart tone is split. 

The second heart sound has a louder aortic sound than usual. 

A diamond-shaped systemic whisper lasts during systole in extreme aortic stenosis. 

The whisper is loud and sharper than the whisper of mild stenosis of the aorta. 

The aortic valve leaflets are caused by calcification.

Mitral Regurgitation

Mitral regurgitation is the reverse oozing of the blood from the mitral valve as the left ventricle contracts.

Hypertensive cardiomyopathy in patients with chronic systemic hypertension (HTN) is a recurrent cardiac condition usually accompanied by intense left ventricular hypertrophy.

The usual murmur of mitral regurgitation is defined by the patient at the apex with the left side of the decubitus as a high-pitched holosystolic murmur. The direction in which the murmur radiates depends on the design of the mitral valve operation.

Mitral Valve prolapse

Mitral prolapse of the valve, also known as MVP, is a condition in which the two mitral valve flaps do not close up smoothly or evenly. 

A medium-tone diamond-shaped murmur starts immediately after a  mid-substantial click and goes to the end of the systole. 

The murmur is a turbulent flow into the left atrium from the left ventricle.

Hypertrophic Cardiomyopathy

As the name indicates, hypertrophic cardiomyopathy is a condition in which there is hypertrophy/thickness of the cardiac walls. The hypertrophic heart walls lead to difficulty in performing normal heart functions.

The heart can’t pump blood normally. This disease rarely shows symptoms; hence the hypertrophic cardiomyopathy remains undiagnosed usually. In a small population of patients, hypertrophic cardiomyopathy shows symptoms like difficulty in breathing, angina, and arrhythmias.

Other symptoms may include fainting after strenuous or even light exercises, irregular heartbeats, and shortness of breath.

This disease is caused by a gene mutation that does not allow the heart muscle to grow in standard thickness. A high-pitched, crescendo-decrescendo, midsystolic murmur is heard at the left lower sternal border on auscultation.

Aortic Sclerosis Musical Murmur

Aortic sclerosis does not show any symptoms. Delayed symptoms of the disease can include fainting, dizziness, tiredness, and chest pain. A vibratory murmur is known as a musical murmur.

On auscultation, aortic sclerosis musical murmur is heard as a loud murmur in the early systolic period. If you observe it on a Waveform tab, a diamond-shaped presentation is seen.

This particular murmur consists of regular vibrations, which give rise to a musical sound hence the name aortic sclerosis musical murmur. The main reason is the improper or turbulent flow of blood into the aorta. Diastole is silent in this condition. For auscultation, the stethoscope should be placed at the aortic region.

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