Systolic Murmurs

Posted by e-Medical PPT Thursday, December 12, 2013
Systolic Murmurs

Definition of murmur
Relatively prolonged series of audible vibrations , Characterized by the timing in  cardiac cycle, intensity (loudness), frequency (pitch), quality, configuration, duration and direction of radiation
Due to disturbance in blood flow which manifest as turbulence

FREEMAN & LEVINE GRADING
GRADE 1-faintest murmur which can be heard only with special effort.
GRADE 2-soft but readily audible
GRADE 3-loud without thrill
GRADE 4-loud with thrill
GRADE 5-heard with steth partially off the chest
GRADE 6-heard with steth held off the chest wall.

Ejection systolic murmur
Most common murmur heard in everyday practice.
“Murmur starting after some time interval from first heart sound and reaching peak by mid-systole or later and ending before the second heart sound of its origin”.
It could be  PATHOLOGICAL or INNOCENT/PHYSIOLOGICAL
    Ventricular outflow obstruction
    Dilation of aorta and pulmonary trunk
    Accelerated systolic flow into aorta or pulmonary trunk
    Innocent midsystolic murmur( including those due to morphological changes of valve with no obstruction)
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