Murmur

Cheat Crescendo/Decrescendo Holosystolic

Sheet

MR (to axilla)
AS (to neck)
TR (inspiration
MVP (click)
Systolic increases)
HOCM
VSD (harsh)

MS (opening
Aortic regurgitation
Diastolic snap)

NOTE: See chart below for abbreviations

Murmur Identification
 Lesion Shape Location Heard Altered by Characteristics
Systolic
"Parvus et tardus" (pulses
Radiates to weak compared to heart
Crescendo- neck sounds)
Aortic stenosis
decrescendo (carotids) -- Follows ejection click
(AS)
and apex (due to halting of valve
leaflets)

venous
return
Hypertrophic Crescendo-
(e.g., Valsalva)
cardiomyopathy decrescendo -- --
- increases
(HOCM)
murmur

TPR
(e.g.,squatting,
hand grip) -
Mid-systolic click (tensing
decreases
of chordae tendinae)
Mitral valve Late murmur
Loudest at S2
prolapse crescendo -- venous
Later with afterload
(MVP) return
(e.g., hand grip).
(e.g., Valsalva)
- increases
murmur

TPR
(e.g.,squatting,
Mitral Radiates hand grip)
Holosystolic High-pitched, blowing
regurgitation toaxilla LA return
(MR) (e.g.,expiration
)

Radiates to RA return
Tricuspid
Holosystolic right sternal (e.g.,inspiratio High-pitched, blowing
regurgitation
border n)
(TR)
Ventricular
Holosystolic Harsh-sounding
septal defect -- --
(VSD)
 Diastolic

Left sternal
border with
Aortic Early High-pitched blowing
patient
regurgitation decrescendo -- heard at end of expiration
leaning
(AR)
forward

Heard
LA return Opening snap (tensing of
inlateral left
Mitral stenosis Late rumble (e.g., expiratio chordae tendinae) in
decubitus
(MS) n) early diastole after A2
position

Other
Machine-
Patent ductus like,continuous/constant
Continuous ULSB
arteriosus -- murmur heard through
(PDA) systole and diastole

Systolic:
ULSB
(pulmonic
Systolic and valve)
Atrial septal
diastolic Diastolic: -- --
defect (ASD)
LLSB
(tricuspid
valve)