A method is described for recording heart sounds and murmurs on the surface of the heart chambers and great vessels. Studies were performed on normal dogs and in those with murmurs of known origin, chiefly pulmonic and aortic stenosis. In addition, the reappearance of the murmurs in such cases was studied, following the release of caval occlusion. It was found that the systolic murmur of pulmon...

Much has been written by physicians about patients referred to them because of the discovery of a systolic murmur. Inevitably such consultant physicians have scant opportunity to judge the incidence, character, and significance of murmurs among apparently healthy people. Freeman and Levine (1933) described the systolic murmurs that they had found in a group they had examined of a thousand perso...

Non-invasive continuous and pulsed wave Doppler ultrasonography was performed in 102 consecutive patients with clinically ill defined systolic murmurs to differentiate between flow murmurs, mitral regurgitation, aortic stenosis, and ventricular septal defect, as well as to assess the severity of aortic stenosis. Diagnoses with the Doppler method were based on velocity, direction, and duration o...

Physiological principles that directly apply to physical diagnosis provide opportune occasions to bring basic science to the bedside. In this article, we describe the effect of cardiac maneuvers on systolic murmurs and how physiological principles apply to the explanation of the changes noted at the bedside. We discuss the effect of Valsalva, squatting, and hand grip maneuvers on different phys...

SYSTOLIC MURMURS heard during the first year of life in apparently healthy children are commonly noted to have disappeared at a later examination." 2 The exact origin of such murmurs is not known but it has been suggested that some are accounted for by exaggeration of the physiologic pulmonary systolic murmur and a few by late closure of the ductus arteriosus. Of particular interest is a small ...

In the course of carrying out routine physical examinations on newborn babies, certain infants were found who presented loud systolic cardiac murmurs in the absence of other abnormal physical signs. The significance of such a finding was doubtful, but the murmur in many cases was so loud as to suggest the possibility of congenital heart disease. An investigation was therefore carried out to ass...

Of the four heart valves, three are tricuspid (aortic, pulmonic, and tricuspid) and one is bicuspid (mitral). Failure of normal function of these valves is due to lesions that make them incompetent and allow backward flow (regurgitation) or to lesions that decrease orifice size and cause restriction of flow (stenosis). In addition, combinations of these lesions may occur within the same valve, ...

t has long been known that patients with anemia often have cardiac murmurs, especially “innocent” or “flow” systolic murmurs. These murmurs are not related to valvular disease; they are, however, related to alterations of cardiac dynamics. Tachycardia, increased cardiac output, and dilatation of the heart result from a significant drop of the hemoglobin level. Thus, the myocardium is stressed b...