Heart Murmur
Basics
Description
Description
- Abnormal heart sounds created by turbulent flow across heart valves or vascular abnormalities
- Systolic murmurs are common findings in adults (15–44%) and children (80–96%)
- 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
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
Schaider, Jeffrey J., et al., editors. "Heart Murmur." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307591/all/Heart_Murmur.
Heart Murmur. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307591/all/Heart_Murmur. Accessed December 7, 2024.
Heart Murmur. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307591/all/Heart_Murmur
Heart Murmur [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 07]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307591/all/Heart_Murmur.
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