Murmurs

Key points

• Ejection systolic: aortic stenosis · pulmonary stenosis · HOCM · ASD · Fallot's.
• Holosystolic (pansystolic): mitral/tricuspid regurgitation (high-pitched, blowing) · VSD (harsh).
• Late systolic: mitral valve prolapse · coarctation of aorta.
• Early diastolic: aortic regurgitation (high-pitched, blowing) · Graham-Steel (pulmonary regurgitation).
• Mid-late diastolic: mitral stenosis (rumbling) · Austin-Flint (severe AR). Continuous machine-like: PDA.

Decision points in this pathway

• When in the cardiac cycle is the murmur?
• Early or mid-late diastolic?
• Ejection, holosystolic or late systolic?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.