Heart Murmur is a topic covered in the 5-Minute Emergency Consult.

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Emergency Central

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Basics

Description

  • Sounds created by physiologic processes or functional and structural anomalies of the heart.
  • Stenotic lesions:
    • Pressure overload in the chamber preceding the valve, leading to hypertrophy of the chamber in an attempt to overcome the increased resistance
  • Regurgitant lesions:
    • Volume overload of the chamber preceding the valve, leading to chamber dilatation in an attempt to accommodate the regurgitant blood volume
  • Genetic abnormalities:
    • Congenital defects associated with abnormal cardiac blood flow

Etiology

  • Aortic stenosis:
    • Rheumatic heart disease
    • Congenital bicuspid valve
    • Calcification
    • Prosthetic valve
  • Aortic regurgitation:
    • Rheumatic heart disease
    • Endocarditis
    • Aortic dissection
    • Prosthetic valve
  • Mitral stenosis:
    • Rheumatic heart disease
    • Rheumatologic disorders (systemic lupus erythematosus)
    • Calcification
    • Cardiac tumors (atrial myxoma)
    • Congenital
    • Prosthetic valve
  • Mitral regurgitation, acute:
    • Endocarditis
    • Papillary muscle rupture or dysfunction
    • Rupture of chordae tendineae
    • Prosthetic valve
  • Mitral regurgitation, chronic:
    • Rheumatic heart disease
    • Mitral valve prolapse
    • Connective tissue disease (Marfan syndrome)
  • Mitral valve prolapse:
    • Congenital
    • Connective tissue disease
  • Tricuspid stenosis:
    • Rheumatic heart disease
  • Tricuspid regurgitation:
    • Rheumatic heart disease
    • Endocarditis
    • Pulmonary HTN
  • Pericardial friction rub:
    • Pericarditis
    • Pericardial effusion
  • Ventricular septal defect:
    • Congenital
    • Traumatic
    • Postinfarction
  • Ventricular assist device
    • Implantable pump supplements or replaces ventricular function

Pediatric Considerations
  • Pulmonic stenosis:
    • Congenital
    • Maternal–fetal rubella exposure
    • Rheumatic heart disease
  • Pulmonic regurgitation:
    • Congenital
    • Rheumatic heart disease
    • Pulmonary HTN
  • Atrial septal defect:
    • Congenital
  • Patent ductus arteriosus:
    • Congenital
    • Prematurity
    • Maternal–fetal rubella exposure
  • Coarctation of the aorta:
    • Congenital
    • Turner syndrome
  • Hypertrophic cardiomyopathy/idiopathic hypertrophic subaortic stenosis:
    • Congenital
    • Genetic predisposition

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Citation

* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Heart Murmur ID - 307591 Y1 - 2016 PB - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307591/all/Heart_Murmur ER -