Systolic Murmur

Systolic Murmur - Learning Issue: Significance of Systolic...

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Learning Issue: Significance of Systolic Murmurs-MH Systolic murmurs are common in bedside findings, occurring in 5% to 52% of young adults and 29% 60% of older patients. More than 90% of younger adults and more than half of older adults with systolic murmurs have a normal echocardiogram, which indicates an “innocent murmur.” Systolic murmurs need to be addressed whether they are functional or organic. Functional murmur o Are short, early or mid-systolic murmurs of grade 2/6 or less. o They are well localized to the area of the left sternal border, and they diminish in intensity the patients stands, sits up, or strains during the valsalva maneuver. o Patients with functional murmurs have normal neck veins, apical impulse, arterial, and heart tones. o An abnormal heart examination refers to any murmur not meeting the definition of a functional murmur. Organic murmur o If the murmur is organic, the clinician should then address which lesion is responsible. Timing and location o Despite classic teachings, the timing and location of a systolic murmur often do not distinguish aortic stenosis from mitral regurgitation (e.g. late systolic, mitral
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Systolic Murmur - Learning Issue: Significance of Systolic...

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