• Timing
  • When do murmurs occur?
    • Systole, Diastole
    • Early or late in systole or diastole?
    • Does it occur through out the heart cycle?
    • Does the intensity of the sound vary over time?


    UNDERSTANDING CARDIAC MURMUR SONOGRAMS

  • Sonogram is a graphical depiction of sound

  • The following sonogram depicts a mid-diastolic decrescendo murmur

    • The red area depicts the sound which occurs between S2 and S1 hence diastolic murmur
    • The sound starts after S2 and ends before S1 hence a mid-diastolic murmur
    • The sound starts loud and decreases hence a decrescendo murmur.

  • The following sonogram depicts a pansystolic murmur or holosystolic murmur

    • Red area depicts sound which occurs between S1 and S2 hence a systolic" murmur
    • The sound is pansystolic or holosystolic murmur
    • The sound intensity does not vary throughout the murmur hence holosystolic

  • The following sonogram depicts a late systolic crescendo murmur with a midsystolic click

    • Red area depicts sound occurs between S1 and S2 hence a systolic murmur
    • Sound begins in the middle of systole and ends with diastole hence a late systolic murmur
    • Sound increases in intensity through the end of systole hence a crescendo murmur
    • The sonogram depicts a spike mid-systole representing a midsystolic ejection click

  • The following is a midsystolic crescendo-decrescendo or diamond-shaped murmur

    • Red area depicts sound occurring between S1 and S2 hence a systolic murmur
    • Sound begins after S1 and ends before S2 hence midsystolic
    • Sound increases in intensity then decreases hence crescendo-decrescendo murmur
    • This murmur is also known as a systolic ejection murmur